利培酮和齐拉西酮对首发精神分裂症患者机体代谢的影响

The effect of risperidone and ziprasidone for metabolism in patients with first-episode schizophrenia

目的分析利培酮和齐拉西酮对首发精神分裂症患者机体代谢的影响。方法104例首发精神分裂症患者,根据治疗药物不同分为利培酮组和齐拉西酮组,每组52例。利培酮组口服利培酮治疗,齐拉西酮组口服齐拉西酮治疗。比较两组治疗前及治疗6、12周代谢指标[空腹血糖(FBG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)],治疗6周内、治疗第7~12周代谢综合征(MS)发生情况,临床疗效。结果利培酮组治疗6、12周的FBG、TG水平均高于本组治疗前,治疗12周的HDL-C水平低于本组治疗前,差异具有统计学意义(P<0.05);齐拉西酮组治疗12周的FBG水平高于本组治疗前,差异具有统计学意义(P<0.05)。治疗6、12周,齐拉西酮组TG水平明显低于利培酮组,差异具有统计学意义(P<0.05)。治疗6周内、治疗第7~12周,齐拉西酮组MS发生率分别为11.54%、19.23%,均明显低于利培酮组的40.38%、51.92%,差异具有统计学意义(P<0.05)。两组治疗总有效率比较差异无统计学意义(P>0.05)。结论利培酮和齐拉西酮治疗首发精神分裂症患者均具有显著的临床疗效,但利培酮对患者机体代谢的影响较大,容易引发MS,齐拉西酮安全性相对较高。

Objective To analyze the effect of risperidone and ziprasidone for metabolism in patients with first-episode schizophrenia.Methods A total of 104 patients with first-episode schizophrenia were divided into risperidone group and ziprasidone group according to different treatment drugs,with 52 cases in each group.Risperidone group was treated with oral risperidone,and ziprasidone group was treated with oral ziprasidone.The metabolic indexes[fasting blood glucose(FBG),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C)]before treatment,and after 6 and 12 months of treatment,occurrence of metabolic syndrome(MS)within 6 weeks of treatment and after 7-12 weeks of treatment,and clinical efficacy were compared between the two groups.Results After 6 and 12 months of treatment,the FBG and TG of risperidone group were higher than those before treatment,and HDL-C after 12 weeks of treatment was lower than that before treatment.All the difference was statistically significant(P<0.05).After 12 weeks of treatment,the FBG of ziprasidone group was higher than that before treatment,and the difference was statistically significant(P<0.05).After 6 and 12 months of treatment,the TG of ziprasidone group was higher than that of risperidone group,and the difference was statistically significant(P<0.05).Within 6 weeks of treatment and after 7-12 weeks of treatment,the incidence of MS of ziprasidone group were 11.54%and 19.23%,which were obviously lower than 40.38%and 51.92%of risperidone group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in total effective rate between the two groups(P>0.05).Conclusion Both risperidone and ziprasidone have significant clinical efficacy on patients with first-episode schizophrenia,but the risperidone has great influence on metabolism,and is likely to cause MS,and the security of ziprasidone is relatively higher.