利培酮联合小剂量阿立哌唑对精神分裂症患者血清神经递质、糖脂代谢及BMI的影响

Effects of Risperidone Combined with Low Dose Aripiprazole on Serum Neurotransmitter, Glycolipid Metabolism and BMI in Patients with Schizophrenia

目的:探讨利培酮联合小剂量阿立哌唑治疗对精神分裂症患者血清神经递质、糖脂代谢及体质量指数(BMI)的影响。方法:选取2016年1月~2018年10月期间我院收治的80例精神分裂症患者,根据随机数字表法将患者分为对照组(n=40)和研究组(n=40),对照组予以利培酮治疗,研究组在对照组基础上联合小剂量阿立哌唑治疗,比较两组患者疗效、阳性和阴性症状评定量表(PANSS)评分、血清神经递质[多巴胺、去甲肾上腺素(NE)、5-羟吲哚乙酸(5-HIAA)]和糖脂代谢[血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)],记录两组治疗期间不良反应情况。结果:研究组治疗4周后临床总有效率为97.50%(39/40),高于对照组的82.50%(33/40)(P<0.05)。两组治疗4周后PANSS中的阴性症状评分、阳性症状评分、一般病理评分、总分、FPG、TC、TG及血清多巴胺水平均较治疗前下降,且研究组低于对照组(P<0.05)。两组患者治疗4周后血清NE、5-HIAA水平均升高,且研究组高于对照组(P<0.05)。两组患者治疗4周后BMI均略有增加,但差异无统计学意义(均P>0.05)。研究组、对照组不良反应总发生率分别为15.00%(6/40)、12.50%(5/40),二者比较无差异(P>0.05)。结论:利培酮联合小剂量阿立哌唑治疗精神分裂症患者可提高其临床疗效,可有效改善血清神经递质水平,对机体糖脂代谢和BMI影响轻微,且用药安全性较好。

Objective: To investigate the effect of risperidone combined with low dose aripiprazole on serum neurotransmitter,glycolipid metabolism and(body mass index, BMI) in patients with schizophrenia. Methods: 80 schizophrenics who were admitted to our hospital from January 2016 to October 2018 were selected, they were divided into control group(n=40) and study group(n=40)according to the random number table method. The control group was treated with risperidone. The study group was treated with low-dose aripiprazole on the basis of the control group, and the efficacy, sexual and negative symptom scale(PANSS) scores, serum neurotransmitters [dopamine, noradrenaline(NE), 5-hydroxyindoleacetic acid(5-HIAA)] and glycolipid metabolism [blood glucose(FPG), total cholesterol(TC), triacylglycerol(TG)]of the two groups were compared, adverse reactions during treatment were recorded.Results: The total effective rate in the study group at 4 weeks after treatment was 97.50%(39/40), which was higher than 82.50%(33/40)in the control group(P<0.05). The negative symptom score, positive symptom score, general pathological score, total score, FPG, TC, TG and serum dopamine levels of PANSS in the two groups at 4 weeks after treatment all decreased compared with those before treatment,and those in the study group were lower than those in the control group(P<0.05). 4 weeks after treatment, serum NE and 5-HIAA levels increased in both groups, and those in the study group were higher than those in the control group(P<0.05). BMI increased slightly in both groups at 4 weeks after treatment, but the difference was not statistically significant(all P>0.05). The total incidence of adverse reactions in the study group and control group were 15.00%(6/40) and 12.50%(5/40), respectively, with no difference(P>0.05).Conclusion: Risperidone combined with low-dose aripiprazole is effective in the treatment of schizophrenia. It can effectively improve serum neurotransmitters, slightly affect the glycolipid metabolism and BMI, and it has a good safety.