阿立哌唑对奥氮平治疗精神分裂症后患者体质量增加的临床效果

Clinical effect of aripiprazole on olanzapine in the treatment of post-schizophrenia patients with increased body weight

目的 探讨阿立哌唑对奥氮平治疗精神分裂症后患者体质量增加的临床效果及对血清瘦素（leptin）、泌乳素（PRL）与体质量的影响。方法 选取2013年2月～2015年8月台州市第二人民医院收治的92例奥氮平所致精神分裂症体质量增加患者,依抽签法分为对照组和实验组,各46例,对照组予以奥氮平维持治疗,实验组在对照组基础上加以阿立哌唑治疗,比较2组血清瘦素、泌乳素、脂联素、空腹血糖、胰岛素抵抗指数、血脂、体质量、体质量指数、腹围,阳性与阴性症状量表（PANSS）评分和不良反应。结果治疗后,实验组血清瘦素和泌乳素分别为（19.46±2.70）μg/L和（470.31±67.25）m IU/L低于对照组（28.78±4.11）μg/L和（730.62±91.25）m IU/L（P〈0.05）。实验组脂联素为（19.40±2.70）mg/L显著高于对照组（13.96±1.73）mg/L;实验组空腹血糖和胰岛素抵抗指数分别为（4.53±0.56）mmol/L和（2.11±0.26）,低于对照组（6.85±0.85）mmol/L和（4.35±0.62）（P〈0.05）;实验组血脂水平优于对照组（P〈0.05）。实验组体质量、体质量指数、腹围显著低于对照组（P〈0.05）;实验组PANSS评分优于对照组（P〈0.05）。2组不良反应比较差异无统计学意义。结论 阿立哌唑对奥氮平所致精神分裂症体质量增加患者的效果确切,可有效降低患者血清瘦素、泌乳素及体质量。

Objective To research of aripiprazole in schizophrenia patients with olanzapine-induced weight gain and The influence on serum leptin, prolactin （ PRL） and weight.Methods 92 cases of schizophrenia patients with olanzapine-induced weight gain in the draw method was divided into control group and experimental group, all the 46 cases, the control group was treated with olanzapine,the experimental group based on the control treated with aripiprazole.Leptin, PRL, adiponectin, fasting plasma glucose, insulin resistance index, blood lipid, weight, body mass index, abdominal circumference, positive and negative symptom scale （ PANSS ） score and adverse reactions were compared between two groups.Results After treatmented, the leptin and PRL of experimental group was lower than the control group （19.46 ±2.70） μg/L, （470.31 ±67.25） mIU/L vs （28.78 ± 4.11） μg/L, （730.62 ±91.25） mIU/L, the difference was statistically significant （P〈0.05）.The adiponectin of experimental group was higher than the control group （19.40 ±2.70） mg/L vs （13.96 ±1.73） mg/L, the fasting plasma glucose, insulin resistance index of experimental group was lower than the control group （4.53 ±0.56）mmol/L, （2.11 ±0.26） vs （6.85 ±0.85） mmol/L, （4.35 ±0.62） （P〈0.05）.The blood lipid level of experimental group was better than that of control group （P〈0.05）.The body weight, fasting blood glucose, insulin resistance index of experimental group was lower than the control group （ P〈0.05 ） .The PANSS score of experimental group was better than that of control group （ P〈0.05 ） .The adverse reactions was no differences between the two groups.Conclusion The exact clinical effect of aripiprazole in schizophrenia patients with olanzapine-induced weight gain is effective,can decrease the serum leptin, PRL and weight.