二甲双胍早期干预对非典型抗精神病药物所致精神病患者代谢综合征的预防作用

Prevention effect of metformin for early intervention in metabolic syndrome caused by atypical antipsychotics in psychiatric patients

目的探讨二甲双胍早期干预对非典型抗精神病药物所致精神病患者代谢综合征的预防作用。方法选取2013年7月-2015年4月间在佛山市第三人民医院住院的精神病患者160例,采用随机数字表法将患者分为实验组和对照组各80例,实验组采用二甲双胍治疗,对照组采用饮食、运动干预。在治疗前(0周)及治疗第4、8、12周末测量身高、体重、腰围、空腹血糖(FPG)、餐后2小时血糖(2h PG)、血脂、血压,计算体重指数(BMI)。结果治疗4、8、12周后,实验组BMI、FPG、高密度脂蛋白(HDL)、舒张压(DBP)、收缩压(SBP)均低于治疗前,差异有统计学意义(P<0.05),腰围、2h PG、甘油三酯(TG)随治疗时间的延长其差异无统计学意义(P>0.05);对照组BMI、腰围、FPG、TG均较治疗前高,差异有统计学意义(P<0.05),2h PG、HDL、DBP、SBP与治疗前比较差异无统计学意义(P>0.05)。治疗前两组BMI、腰围、FPG、2h PG、TG、HDL、DBP、SBP数据比较差异均无统计学意义(P>0.05);治疗4、8、12周后,实验组BMI、腰围、FPG、TG、HDL、DBP、SBP均低于对照组(P<0.05),两组2h PG比较差异无统计学意义(P>0.05)。结论与采用饮食、运动干预相比,二甲双胍能预防非典型抗精神病药物所致代谢综合征的发生,对临床应用有一定的参考价值。

Objective To study the early prevention of metformin for psychotics with metabolic syndrome caused by atypical antipsychotics. Methods A total of 160 psychiatric patients who were treated with atypical antipsychotics and hospitalized from July2013 to April 2015 were randomly divided into two groups by the random number table: experimental group treated with metformin( n =80),control group treated with diet and exercise intervention( n = 80). The indicators including height,weight,waist circumference,fasting plasma glucose( FPG),2 hours postprandial blood glucose( 2h PG),blood fat,blood pressure were measured and recorded among all patients before treatment( 0 weeks),treatment of 4 weeks,8 weeks and 12 weeks respectively,then the body mass index( BMI) was calculated. Results In experimental group,when treatment time was prolonged( treatment of 4 weeks,8 weeks and 12weeks),the BMI,FPG,HDL,DBP and SBP levels were lower than prior treatment( 0 weeks,P < 0. 05). While the waist circumference,2h PG and TG levels had no statistical difference( P > 0. 05). Similarly,when treatment time was prolonged( treatment of 4weeks,8 weeks and 12 weeks),in control group,the BMI,waist circumference,FPG and TG levels were higher than prior treatment( P < 0. 05). While the 2h PG,HDL,DBP and SBP levels had no statistical difference( P >0. 05). Finally,we compared the therapeutic effect between two groups,all the recorded indicators had no statistical difference before treatment( P > 0. 05). But when treatment time was prolonged( treatment of 4 weeks,8 weeks and 12 weeks),the BMI,waist circumference,FPG,TG,HDL,DBP and SBP levels of experimental group were lower than control group( P < 0. 05),while 2h PG between two groups had no statistical difference( P > 0. 05).Conclusion Comparing to control group,treatment with diet and exercise intervention,metformin can prevent the occurrence of the metabolic syndrome caused by atypical antipsychotics,and there is certain value for clinical application.