不同第二代抗精神病药物治疗精神分裂症效果及对糖脂代谢影响研究

Study on the effect of different second-generation antipsychotics on schizophrenia and the effect of them on glucose and lipid metabolism

目的探讨3种第二代抗精神病药物治疗精神分裂症的效果和对糖脂代谢的影响。方法将2016年12月至2019年12月在该院住院治疗的90例精神分裂症住院患者随机分为三组,各30例,分别给予齐拉西酮、利培酮和阿立哌唑治疗。在基线、第4周末和第8周末采用阳性和阴性症状量表(PANSS)评估各组疗效,比较基线和治疗后各组患者体重指数(BMI)、空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度胆固醇(HDL-C)及低密度胆固醇(LDL-C)变化。结果各组性别、年龄、受教育年限、病程和基线时PANSS评分比较,差异均无统计学意义(P>0.05);第4周末,利培酮组PANSS评分显著低于齐拉西酮组和阿立哌唑组,差异均有统计学意义(P<0.05);第8周末,三组PANSS评分比较,差异无统计学意义(P>0.05)。同组治疗前后比较,利培酮和阿立哌唑组患者BMI显著升高,齐拉西酮和利培酮组TC水平显著升高,利培酮组LDL-C水平显著升高,差异均有统计学意义(P<0.05)。治疗后,利培酮组TC水平显著高于齐拉西酮组和阿立哌唑组,LDL-C水平和BMI显著高于齐拉西酮组,差异均有统计学意义(P<0.05)。结论利培酮起效快于齐拉西酮和阿立哌唑,利培酮对患者体重增加、TC和LDL-C影响大于齐拉西酮和阿立哌唑,齐拉西酮对体重增加影响较小。

Objective To explore the effect of three second-generation antipsychotics on schizophrenia and the effect of them on glucose and lipid metabolism.Methods The 90 patients with schizophrenia who were hospitalized in the hospital from December 2016 to December 2019 were randomly divided into 3 groups,30 cases in each group,and them were treated with ziprasidone,risperidone or aripiprazole,respectively.Mental status of patients was evaluated by PANSS at baseline and after 4 and 8 weeks of treatment.The body mass index(BMI),fasting blood glucose(FPG),triglyceride(TG),total cholesterol(TC),high density lipoprotein protein(HDL-C)and low density liprotein protein(LDL-C)were compared between the three groups before and after treatment.Results There was no significant difference in gender,age,years of education,course of disease and score of PANSS(P>0.05).At the end of the fourth week,the PANSS score of risperidone group was significantly lower than that of ziprasidone group and aripiprazole group,the differences were statistically significant(P<0.05).At the end of the eighth week,there was no significant difference in the scores of PANSS between the three groups(P>0.05).Comparison of the same group,BMI of risperidone group and aripiprazole group after treatment were significantly higher than before treatment,the level of TC in ziprasidone group and risperidone groups wwere significantly higher than before treatment,the level of LDL-C in risperidone group was significantly higher than before treatment,the differences were statistically significant(P<0.05).After treatment,the level of TC in risperidone group was significantly higher than that of ziprasidone group and aripiprazole group,the differences were statistically significant(P<0.05).The levels of LDL-C and BMI in risperidone group were significantly higher than those in ziprasidone group,the differences were statistically significant(P<0.05).Conclusion Risperidone takes effect faster than ziprasidone and aripiprazole,the effect of risperidone on weight gain,TC and LDL-C are greater than those of ziprasidone and aripiprazole.Ziprasidone has little effect on weight gain.