二甲双胍对氯氮平所致的双相情感障碍患者代谢综合征的治疗效果

Efficacy of Metformin on Metabolic Syndrome in Patients with Bipolar Affective Disorder Induced by Clozapine

目的探讨二甲双胍对氯氮平所致的双相情感障碍患者代谢综合征的治疗效果。方法选取本溪市康宁医院2017年1—12月收治的氯氮平所致的双向情感障碍合并代谢综合征患者50例作为研究对象,根据有无使用二甲双胍分为对照组(未使用二甲双胍)23例和观察组(使用二甲双胍)27例。比较两组患者治疗前后体重指数(BMI)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、血清总胆固醇(TC)、三酰甘油(TG)以及汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、BechRafaelsen躁狂量表(BMRS)、简易精神状态量表(MMSE)指标变化和用药期间不良反应发生率。结果治疗后观察组患者BMI、HDL、TG以及HAMA、HAMD、BMRS、MMSE优于对照组,差异有统计学意义(P<0.05);观察组患者用药期间不良反应发生率18.52%与对照组30.43%比较,差异无统计学意义(P>0.05)。结论采用氯氮平治疗的双相情感障碍合并代谢综合征患者以二甲双胍调节的效果明显,可以对患者BMI、HDL、TG水平进行充分改善,并有效改善患者的心理状态,且安全性较高。

Objective To explore efficacy of metformin on metabolic syndrome in patients with bipolar affective disorder induced by clozapine.Methods From January to December 2017,50 patients with bipolar affective disorder complicated with metabolic syndrome caused by clozapine admitted in Benxi Kangning Hospital were enrolled as research subjects.According to whether or not metformin was used,the patients were divided into control group(metformin was unused,n=23)and observation group(metformin was used,n=27).Indicator changes of body mass index(BMI),high density lipoprotein cholesterol(HDL),low density lipoprotein cholesterol(LDL),serum total cholesterol(TC),triacylglycerol(TG),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),BechRafaelsen mania rating scale(BMRS)and mini-mental state examination(MMSE)were compared between the 2 groups before and after the treatment,as well as incidence rates of adverse reactions during the treatment.Results After the treatment,the BMI,HDL,TG,HAMA,HAMD,BMRS and MMSE in the observation group were better than those in the control group.The differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group during the treatment was 18.52%while 30.43%in the control group,and the difference was not statistically significant(P>0.05).Conclusion The efficacy of metformin is obvious in patients with bipolar affective disorder combined with metabolic syndrome treated with clozapine.It can improve the BMI,HDL and TG levels in the patients and effectively improve the patients’psychological states,with high safety.