丙戊酸钠联合利培酮对癫痫性精神障碍患者血清25(OH)D3、糖脂代谢及睡眠质量的影响

Effects of sodium valproate combined with risperidone on serum 25(OH)D3,glucose and lipid metabolism and sleep quality in patients with epileptic mental disorder

目的探讨丙戊酸钠联合利培酮对癫痫性精神障碍患者血清25-(OH)D3、糖脂代谢与睡眠障碍的影响。方法纳入2016年4月至2018年12月南阳市中心医院神经内科收治的癫痫性精神障碍患者102例,按照随机数字表法分为观察组和对照组,每组各51例;观察组采用丙戊酸钠+利培酮治疗,对照组采用丙戊酸钠+安慰剂治疗,连续治疗3个月;观察比较两组患者治疗后的阳性与阴性症状量表(PANSS)、简易精神状态检查量表(MMSE)和匹茨堡睡眠质量指数量表(PSQI)评分,检测并比较两组患者治疗前后血脂、空腹血糖、血清25-(OH)D3水平变化。结果治疗后,观察组PANSS阳性症状、阴性症状和PSQI评分低于对照组(P<0.05);两组患者血清TG、TC、FBG水平均较治疗前升高,25-(OH)D3水平较前降低,且观察组糖脂代谢水平低于对照组,25-(OH)D3水平高于对照组(P>0.05);两组患者治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论丙戊酸钠联合利培酮治疗癫痫性精神障碍疗效显著,改善患者睡眠质量;但治疗期间需要注意监测血脂、血糖、血钙浓度变化,减少不良反应。

Objective To investigate the effects of sodium valproate combined with risperidone on serum 25(OH)D3,glucose and lipid metabolism and sleep quality in patients with epileptic mental disorder.Methods A total of 102 patients with epileptic mental disorders admitted in the Department of Neurology,Nanyang Central Hospital from April 2016 to December 2018 were included.They were divided into an observation group and a control group according to the random number table method,with 51 cases in each group.The observation group was treated with sodium valproate+risperidone,and the control group was treated with sodium valproate+placebo.The positive and negative symptom scale(PANSS),simple mental state examination scale(MMSE)and pittsburgh sleep quality index(PSQI)scores in the two groups after treatment were observed,and the changes of serum lipid,fasting blood glucose and 25-(OH)D3 levels in the two groups before and after treatment were detected and compared.Results After treatment,positive symptoms,negative symptoms and PSQI scores in the observation group were lower than those in the control group(P<0.05).Serum levels of TG,TC and FBG in both groups were higher than those before treatment,and 25-(OH)D3 level was lower than that before treatment,the glucose and lipid metabolism level in the observation group was lower than that in the control group,and the 25-(OH)D3 level was higher than that in the control group(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Valproate sodium combined with risperidone is effective in the treatment of epileptic mental disorder and improves the sleep quality of patients.However,during the treatment,attention should be paid to monitor changes in blood lipid,glucose and calcium concentration to reduce adverse reactions.