阿立哌唑对接受氯氮平治疗肥胖精神分裂症患者的代谢影响研究

Metabolic Effects of Aripiprazole Added to Obese Clozapine-Treated Schizophrenia Patients

目的探讨阿立哌唑对接受氯氮平治疗肥胖精神分裂症患者的代谢效应的影响。方法选取接受氯氮平治疗的肥胖精神分裂症患者80例,随机分为研究组和对照组各40例。研究组在原有氯氮平治疗的基础上联合阿立哌唑(5～15 mg/d)治疗,对照组继续维持原氯氮平治疗方案。在入组时、治疗第8周、第24周测量患者的体质量、血糖及血脂,使用临床总体印象量表(CGI)及治疗中需处理的不良反应症状量表(TESS)评估患者精神症状严重程度及不良反应。结果对照组中38位患者完成研究,研究组中36位患者完成研究。研究组的体质量(F=111.673,P<0.01)、腰围(F=78.018,P<0.01)及体质量指数(F=111.203,P<0.01)下降幅度大于对照组,胆固醇升高幅度小于对照组(F=3.779,P<0.05),甘油三酯下降幅度大于对照组(F=22.660,P<0.01)。两组间不良反应发生率比较,差异无统计学意义(P>0.05)。结论联合阿立哌唑可以减轻接受氯氮平治疗的肥胖精神分裂症患者的体质量增加和血脂代谢紊乱。

Objective To explore the metabolic effects ofaripiprazole on obese schizophrenic patients treated by clozapine. Methods A sample of 80 obese schizophrenic patients treated by clozapine was randomly divided into study group and control group equally. Patients in study group were prescribed aripiprazole （5 ？15 mg/ d） adjunctive with clozapine,while those in control group were treated by clozapine alone. Body weight, blood glucose and blood lipid were collected before treatment, 8 weeks after treatment, and 24 weeks after treatment; in the meanwhile,Clinical Global Impression（CGI） and Treatment Emergent Symptoms Scale（TESS） were used to assess the severity of clinical symptoms and adverse effects. Results 38 patients completed the research in the control group,and 36 patients completed the research in the study group. In the study group,body weight （F = 111.673, P 〈0.01）, waist （F = 78.018, P 〈0.01）, and BMI （F = 111.203, P 〈0.01） dropped of f significantly than the control group,the increase o f cholesterol was less than the control group （F = 3.779, P 〈0.05）, the triglyceride declined more significantly than the control group （F = 22.660, P 〈0.01）. There was no difference in the incidence o f adverse effects between the two groups （ P 〉0.05）. Conclusions Aripiprazole adjunctive with clozapine prescribed on obese schizophrenic patients can help in the body weight reduction and therapy ofblood lipid metabolic disorder.