利培酮与齐拉西酮对精神分裂症患者糖脂代谢和细胞因子水平的影响研究

Effects of Risperidone and Ziprasidone on Glucolipid Metabolism and Cytokines of Schizophrenia Patients

目的：观察利培酮与齐拉西酮对精神分裂症患者糖脂代谢和细胞因子水平的影响。方法：选择76例精神分裂症患者,随机均分为利培酮组和齐拉西酮组。利培酮组患者口服利培酮片,起始剂量为1 mg/d,1周内逐渐加量至4-6 mg/d;齐拉西酮组患者口服齐拉西酮片,起始剂量为40 mg/d,分2次服用,1周内逐渐加量至120-160 mg/d。两组患者均以2周为1个疗程,共治疗4个疗程。比较患者治疗前后血糖、胰岛素、血脂、瘦素（LEP）和细胞因子水平。结果：治疗后两组患者血糖、胰岛素、血脂、LEP水平均较治疗前显著升高,治疗前后比较差异大多有统计学意义（P〈0.05）,且齐拉西酮组患者空腹胰岛素（FINS）、胰岛素敏感指数（ISI）、LEP升高较利培酮组更显著,利培酮组患者总胆固醇（TC）升高较齐拉西酮组更显著,两组比较差异均有统计学意义（P〈0.05）;治疗后两组患者细胞因子水平均较治疗前显著降低,治疗前后比较差异均有统计学意义（P〈0.05）,且利培酮组患者细胞因子水平的改善均优于齐拉西酮组,两组比较差异均有统计学意义（P〈0.05）。结论：利培酮与齐拉西酮均可能使精神分裂症患者超重、肥胖和糖尿病的发生率升高,利培酮对患者TC影响较大,齐拉西酮对患者FINS、ISI和LEP影响较大,同时两药可降低精神分裂症患者的细胞因子水平,利培酮对细胞因子水平的改善优于齐拉西酮。

OBJECTIVE：To observe the effect of risperidone and ziprasidone on glucolipid metabolism and cytokine of schizophrenia patients. METHODS：76 schizophrenia patients were randomly divided into risperidone group and ziprasidone group. Risperidone group was given Risperidone tablet orally with initial dose of 1 mg/d,increasing to 4-6 mg/d with one week;Ziprasidone group was given Ziprasidone tablet orally with initial dose of 40 mg/d in 2 installments,increasing to 120-160 mg/d with one week;a treatment course of 2 groups lasted for 2 weeks,and they received 4 courses of treatment. The blood glucose,insulin,blood lipid,leptin（LEP）and cytokine levels were compared before and after treatment. RESULTS：Compared with before treatment,blood glucose,insulin,blood lipid and LEP of 2 groups were significantly increased after treatment;there was statistical significance（P〈0.05）. The increase of FINS,ISI and LEP in ziprasidone group were more significant than in risperidone group,while the increase of TC in risperidone group was more significant than in ziprasidone group;there was statistical significance（P〈0.05）;compared with before treatment,cytokine levels of 2 groups were decreased significantly after treatment;there was statistical significance（P〈0.05）;the improvement of cytokine in risperidone group was better than in ziprasidone group;there was statistical significance（P〈0.05）. CONCLUSIONS：Risperidone and ziprasidone may increase the incidence of overweight,obesity and diabetes in schizophrenia patients;risperidone has great influence on TC,but ziprasidone has great influence on FINS,ISI and LEP. Two medicines also can reduce plasma cytokine levels in patients with schizophrenia,and on the risperidone is better than ziprasidone in the improvement of cytokines levels.