非典型抗精神病药对精神分裂症患者超敏C反应蛋白及血脂代谢的影响

Effects of Atypical Anipsychotic Drugs on the High-sensitivity C-reactive Protein and Blood Lipid in Patients with Schizophrenia

目的:探讨4种非典型抗精神病药对精神分裂症患者超敏C反应蛋白及血脂代谢的影响。方法:将115例连续住院的精神分裂症患者随机分为氯氮平组(29例)、利培酮组(29例)、奥氮平组(28例)、阿立哌唑组(29例),设正常对照组(30例)。均观察12周。在治疗前和治疗12周后分别检测各组的超敏C反应蛋白(hs-CRP)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A1(APoA1)、载脂蛋白B(APoB)。测量身高和体重,并计算体质量指数(BMI)。结果:112周后氯氮平组、利培酮组、奥氮平组的hs-CPR(t=-3.512,-21.272,-3.364)、TG(t=-3.431,-3.442,-3.766)、TC(t=-3.260,-17.395,-17.626)、HDL(t=7.634,10.932,8.627)、LDL(t=-3.910,-4.339,-4.274)、BMI(t=-69.570,-33.204,-60.610)均较前有明显差异(P<0.05);奥氮平组还包括ApoB较前有明显差异(t=-3.173,P<0.05);阿立哌唑组TC(t=-18.974)、LDL(t=-3.230)、BMI(t=-4.743)较前有明显差异(P<0.05);健康对照组的各项指标较前均无明显差异(P>0.05);2治疗12周后各组通过LSD两两比较:氯氮平组、奥氮平组患者hs-CRP明显升高(P<0.05);氯氮平组、利培酮组和奥氮平组的TC、HDL明显升高(P<0.05);氯氮平组的BMI明显高于其他4组(P<0.05)。结论:氯氮平、利培酮、奥氮平均有导致hs-CPR、血脂及BMI增高的可能性,将来可能发生心血管疾病的风险也明显增高。

Objective：To explore the effects of four kinds of atypical anti-psychotic drugs on the levels of high -sensitivity C-reactive protein and blood lipid in patients with schizophrenia .Methods：115 patients with schizophreni‐a were randomly divided into four groups：Clozapine group（n=29） ,risperidone group（n=29） ,olanzapine group（n=28） ,and aripiprazole group（n=29） .Setting one control group（n=30） .The follow -up examination of each group was performed for 12 weeks .The levels of high-sensitivity C -reactive protein（hs-CRP） ,triglyceride（TG） ,total chole-sterol（TC） ,high-density lipoprotei ,n（HDL） ,low -density lipoprotein（LDL） ,apolipoproteinA1（APoA1） , apolipoproteinB（APoB）were measured before and after the treatment course ,respectively .The waist circumference , height and weight were also measured to evaluate the body mass index（BMI） .Results：① After 12 weeks ,the levels of hs-CRP（t=‐3 5.12 ,‐21 2.72 ,‐3 3.64） ,TG（t=‐3 4.31 ,‐3 4.42 ,‐3 7.66） ,TC（t=‐3 2.60 ,‐17 3.95 ,‐17 6.26） ,HDL（t=7 6.34 ,10 9.32 ,8 6.27） ,LDL（t=‐3 9.10 ,‐4 3.39 ,‐4 2.74） ,BMI（t=‐69 5.70 ,‐33 2.04 ,‐60 6.10）in clozapine group ,risperi‐done group and olanzapine group ,showed clear differences（P〈0 0.5） ,compared with those before tre-atment .The levels of ApoB in olanzapine group were obviously different compared with that before treatment（t=‐3 .173 P〈0 0.5） .The levels of TC（t=‐18 9.74） ,LDL（t=‐3 2.30） ,BMI（t=‐4 7.43）in aripiprazole group were obviously different compared with that before treatment（P0 0.5） .② After 12 weeks ,the levers of hs-CRP in clozapine group and olanzapine group were higher than other groups（P〈0 0.5） .The levels of TC ,HDL in clozapine group ,risperidone group and olanzapine group increased significantly（P〈0 0.5） .The levels of BMI in clozapine group was significantly higher than those in the other groups （P〈0 0.5） .Conclusion：The levels of high -sensitivity C -reactive protein ,blood lipid and body mass index in pa‐tients with schizophrenia are increased by the three factors（clozapine ,risperidone ,olanzapine） .The risk of cardiovas‐cular disease may also significantly increased in the future .