阿立哌唑与奥氮平在首发精神分裂症治疗中的作用及糖脂代谢研究

The Role of Aripiprazole and Olanzapine in the Treatment of First-episode Schizophrenia and the Study of Glycolipid Metabolism

目的探究分析精神分裂症患者分别施予阿立哌唑和奥氮平进行治疗的临床疗效和对糖脂代谢的影。方法将该院2016年11月—2018年11月收治的100例首发精神分裂症患者分成参照组和实验组,各50例,分别施予阿立哌唑与奥氮平进行治疗,观察两组患者的体质量、糖脂代谢情况和PANSS评分。结果①实验组治疗8周后的体质量(62.6±9.5)kg、体质量指数(22.9±2.2)kg/m2优于参照组,差异有统计学意义(t=2.293、2.557,P<0.05);②治疗2周后参照组、实验组的PANSS总均分均优于治疗前(t=2.871、2.543,P<0.05);③治疗8周后参照组空腹血糖(4.8±0.8)mmol/L、空腹胰岛素(8.7±5.2)mIU/L、低密度脂蛋白(2.1±0.8)mmol/L、总胆固醇(4.1±0.9)mmol/L、三酰甘油(1.2±0.5)mmol/L、胰岛素抵抗指数(1.8±1.7)均差于实验组,差异有统计学意义(t=2.998、5.067、4.743、2.936、2.248、5.616,P<0.05)。结论阿立哌唑和奥氮平应用在首发精神分裂症患者治疗中,前者可降低糖脂代谢异常、体质量增重的风险,后者在体质量和糖脂代谢的影响更显著;二者各有各的优势,若患者阴性症状明显则推荐奥氮平。

Objective To analyze the clinical efficacy and the effect on the metabolism of glycolipids in patients with schizophrenia treated with aripiprazole and olanzapine.Methods 100 patients with first-episode schizophrenia admitted to the hospital from November 2016 to November 2018 were divided into a reference group and experimental group,respectively 50 cases.The patients were treated with aripiprazole and olanzapine.Body mass,glycolipid metabolism and PANSS scores were observed in the two groups.Results 1.Body mass(62.6±9.5)kg and body mass index(22.9±2.2)kg/m2 after 8 weeks of treatment in the experimental group were better than the reference group,the difference was statistically significant(t=2.293,2.557,P<0.05);2.treatment for 2 weeks of the total PANSS scores of the post-reference group and the experimental group were better than those before treatment,the difference was statistically significant(t=2.871,2.543,P<0.05).3.After 8 weeks of treatment,the fasting blood glucose(4.8±0.8)mmol/L and fasting insulin(8.7±5.2)mIU/L in the reference group,low density lipoprotein(2.1±0.8)mmol/L,total cholesterol(4.1±0.9)mmol/L,triacylglycerol(1.2±0.5)mmol/L,insulin resistance index(1.8±1.7),both were worse than the experimental group,and the differences were statistically significant(t=2.998,5.067,4.743,2.936,2.248,5.616,P<0.05).Conclusion Aripiprazole and olanzapine are used in the treatment of patients with first-episode schizophrenia.The former can reduce the risk of abnormal glucose and lipid metabolism and weight gain.The latter has more significant effects on body mass and glycolipid metabolism.Each has its own advantages,and olanzapine is recommended if the patient's negative symptoms are obvious.