奥氮平与利培酮对精神分裂症患者脂代谢的影响

Effects of Olanzapine and Risperidone on Lipid Metabolism of Patients with Schizophrenia

目的探讨奥氮平与利培酮治疗精神分裂症患者过程中其对代谢的影响。方法 88例精神分裂症患者随机分为研究组和对照组各44例,研究组应用奥氮平治疗,对照组应用利培酮治疗,治疗2个月后,观察有效率、BMI、TC、TG及阳性症状、阴性症状、PANSS评分等指标。结果研究组有效率为81.8%,对照组79.5%,差异无显著性(χ2=0.073,P>0.05)。治疗前,2组患者阳性症状、阴性症状及PANSS评分无组间差异(t=1.147,0.211,1.377,P>0.05);治疗后,2组患者各项评分均显著降低(t研究组=17.139,5.639,13.338,t对照组=16.236,5.076,14.595,P均<0.05),无组间差异(t=1.123,1.159,0.966,P>0.05)。治疗前,2组BMI、TC及TG水平差异无统计学意义(t=0.955,0.000,0.302,P>0.05);治疗后,研究组各指标较治疗前显著增加(t=3.220,6.439,9.460,P<0.05),且明显高于对照组治疗后水平(t=5.470,5.519,9.381,P<0.05),而对照组治疗前后无明显变化(t=0.347,1.483,0.624,P>0.05)。结论奥氮平与利培酮治疗精神分裂症疗效相近,奥氮平可明显影响患者脂代谢,增加患者体质量。

Objective To discuss the effects of olanzapine and risperidone on the metabolism of patients with schizophrenia. Methods 88 patients with schizophrenia at Shalingzi hospital were randomized into study group （44） treated with olanzapine and control group （44） with risperidone. After two months, effective rate, BMI, TC, TG, positive symptoms, negative symptoms and PANSS scale were observed. Results The effective rates in study group and control group were 81.8% and 79.5%, respectively, without significant difference （χ^2=0. 073, P〉0.05）. Before treatment, there was no significant difference between groups in positive/negative symptom score and PANSS score （t= 1. 147, 0. 211, 1. 377, P〉0. 05）. After treatment, these scores in both groups decreased significantly （tstudy = 17. 139, 5. 639, 13. 338, tcontrol=16. 236, 5. 076, 14. 595, Pall〈0.05）, but there was no significant difference between groups （t=1. 123, 1. 159, 0. 966, P〉0. 05）. Before treatment, there was no significant difference between groups in BMI, TC and TG levels （t=1. 147, 0. 211, 1. 377, P〉0.05）. After treatment, all indexes in the study group increased significantly （t = 3. 220, 6. 439, 9. 460, P〈0.05）, and were higher than those in the control group （t=5. 470, 5. 519, 9. 381, P〈0.05）, but there was no significant change in the control group （t=0. 347, 1. 483, 0. 624, P〉0.05）. Conclusion The curative effect of olanzapine and risperidone on schizophrenia is equivalent, and the former has significant influence on fat and cholesterol metabolism, which can increase body weight.