基因检测指导下奥氮平致精神分裂症患者体质量改变的调查分析

Investigation on weight change in schizophrenia patients induced by olanzapine under guidance of gene detection

目的探讨奥氮平对精神分裂症患者体质量的影响。方法给予5-羟色胺受体2C(5-HTR2C)(-759 C>T)基因型为TT和TC的27例患者奥氮平治疗,比较治疗前和治疗12周后患者体质量、Qvetelet体质量指数、血糖、血脂变化,以及治疗前和治疗2、4、8、12周后患者阳性与阴性症状量表(PANSS)评分。结果治疗12周后,本组患者体质量增加,与治疗前比较差异有统计学意义(P<0.01);Qvetelet体质量指数增加(7.00±2.66)%,与治疗前比较差异无统计学意义(P>0.05);本组患者治疗前后的血糖、胆固醇、甘油三酯、高密度脂蛋白及低密度脂蛋白比较,差异无统计学意义(P>0.05)。奥氮平治疗2周后,本组患者PANSS量表阳性症状、阴性症状、一般症状评分及PANSS总分与治疗前比较,差异均有统计学意义(P<0.01)。结论奥氮平能有效改善精神分裂症患者的精神症状,而医务人员应重视该药引起的体质量增加等不良反应,积极采取早期预防措施,提高患者的治疗依从性和生活质量。

Objective To explore the effect of olanzapine on weight in schizophrenic patients.Methods Totally 27 patients with genotype TT and TC of 5-hydroxytryptamine type 2C receptor( 5-HTR2C)(-759 C > T) were treated by olanzapine. The changes of body mass,Qvetelet body mass index,blood glucose and blood lipid were compared before treatment and 12 weeks after treatment as well as scores of Positive and Negative Symptom Scale( PANSS) before treatment and 2,4,8,12 weeks after treatment were compared. Results After 12 weeks of treatment,the body weight of patients increased significantly when compared to that before treatment( P < 0. 01),while Qvetelet body mass index increased by( 7. 00 ± 2. 66) %,but there was no significant difference before and after treatment( P > 0. 05). There were no significant differences in blood glucose,cholesterol,triglyceride,high density lipoprotein and low density lipoprotein before and after treatment( P > 0. 05).After 2 weeks of olanzapine treatment,the scores of positive symptoms,negative symptoms and general symptom of PANSS as well as total score were significant different from those before treatment( P <0. 01). Conclusion Olanzapine can effectively improve the mental symptoms of patients with schizophrenic. Medical staffs should pay attention to the adverse reactions caused by olanzapine such as weight gain,and actively take early preventive measures to improve the therapeutic compliance and quality of life of patients.