氨磺必利替换奥氮平治疗对伴有代谢综合征精神分裂症患者的影响

The effects of amisulpride replacing olanzapine therapy in schizophrenia patients with metabolic syndrome

目的:观察氨磺必利替换奥氮平治疗对伴有代谢综合征精神分裂症患者的影响。方法:92例奥氮平治疗伴代谢综合征的精神分裂症患者随机分为氨磺必利组(治疗组)及奥氮平组(对照组)各46例。治疗组在2周内将奥氮平换为氨磺必利,对照组维持奥氮平治疗,观察12周。入组时及第6、12周末测量腰围、血压、体质量指数(BMI)及空腹血糖(FBS)、高密度脂蛋白(HDL)、三酰甘油(TG)水平。应用阳性和阴性症状评定量表(PANSS)和治疗中出现的症状量表(TESS)进行疗效和安全性评定。结果:治疗12周末,治疗组腰围、收缩压、BMI、TG、FBS均显著低于对照组(P<0.05或P<0.01),两组PANSS评分差异无统计学意义(P>0.05),而TESS评分治疗组低于对照组(P<0.05)。结论:氨磺必利替换奥氮平治疗对精神分裂症患者体质量增加及代谢综合征有显著改善作用。

Objective：To observe the effects of amisulpride replace olanzapine therapy in schizophrenic patients with metabolic syndrome. Method：Ninety-two schizophrenia patients with metabolic syndrome that primarily used olanzapine were randomly divided into amisulpride group（treatment group）and olanzapine group （control group）,each group 46 cases. In the treatment group we replaced olanzapine with amisulpride within two weeks;In the control group,the olanzapine treatment unchanged;Observation time 12 weeks. At the time of en-rollment and the 6,12 weekend,blood pressure,waist circumference,body mass index（BMI）and fasting blood sugar（FBS）,high density lipoprotein（HDL）,triglycerides（TG）levels were measured,respectively. The clinical situation was assessed by positive and negative symptoms rating scale（PANSS）and treatment emergent side-effect scale（TESS）. Results：After 12 weeks treatment,waist circumference,systolic blood pressure,BMI, TG,FBS of the treatment group were significantly lower than the control group（P 〈 0. 05 or P 〈 0. 01）;PANSS scores of two groups had no significant difference（P 〉 0. 05）,while TESS score of the treatment group was lower than the control group（P 〈 0. 05）. Conclusion：Amisulpride replacing olanzapine in schizophrenia patients can significantly improve weight gain and metabolic syndrome.