不同治疗剂量奥氮平对男性精神分裂症患者血糖血脂的影响

Effects of different doses of olanzapine on blood glucose and lipids in male schizophrenic patients

目的探讨不同治疗剂量奥氮平对男性精神分裂症患者血糖、血脂的影响。方法选择60例男性精神分裂症患者随机分为两组,分别给予5～15 mg/d（低剂量组）和16～25 mg/d（高剂量组）治疗,于治疗前、治疗28 d后测量体重、血糖及血脂水平,同时用阳性症状和阴性症状量表（PANSS）评估精神症状。结果与治疗前相比,治疗28 d后两组患者体重均显著增加（t=11.326,14.355）,差异有统计学意义（P均〈0.01）。治疗后两组间比较体重增加差异无统计学意义。与治疗前相比,治疗后两组患者总胆固醇（total cholesterol,TCH）和甘油三酯（triglyceride,TG）水平均明显升高,差异有统计学意义（P〈0.01）,血糖和高密度脂蛋白（HDL）水平变化不明显,差异无统计学意义（P〉0.05）。两组治疗后比较血糖、血脂指标差异无统计学意义（P〉0.05）。与治疗前相比,治疗后两组PANSS量表分值均明显降低,差异有统计学意义（P〈0.01）。两组患者治疗后PANSS量表分值差异无统计学意义（P〉0.05）。结论奥氮平可导致男性精神分裂症患者血脂和体重增加,可能与治疗剂量无关。

Objective To explore the effects of different doses of olanzapine treatment on blood glucose and lipids in male schizophrenics. Methods Sixty male schizophrenic patients were divided into two groups randomly and olanzapine were given at 5 ～ 15 mg per day（ low dose group） and 16 ～ 25 mg per day（ high dose group）. Weight,blood glucose and lipids were measured before treatment and after 28 days＇ treatment meanwhile PANSS was used to assess the psychological symptoms. Results Weight gains in the two groups were significant after treatment（ t =11. 326,14. 355） and there were significant differences（P〈0. 01）. There was no significant difference in weight gains between groups after treatment. The serum levels of total cholesterol（ TCH） and triglyceride（ TG） in the two groups after treatment were increased than those before treatment and there were significant differences（P〈0. 01）,but there was no significant difference between two groups after treatment. Compared before treatment,there was no significant difference in the levels of glucose and high density lipoprotein-cholesterol（ HDL） in the two groups after treatment and there was no significant difference between the two groups（P〈0. 05）. Compared before treatment,the total scores of PANSS in the two groups were decreased after treatment and there were significant differences（P〈0. 01）,but there was no significant difference between two groups after treatment. Conclusion Olanzapine can increase weight and the level of lipid in male schizoprenic patients and it may not be related with treatment dose.