氯氮平片和氯丙嗪片对慢性精神分裂症患者体质量和糖脂代谢的影响  

Influence of clozapine tablet and chlorpromazine tablet on body weight and metabolism of glucose and lipid in the treatment of chronic schizophrenia patients

作　　者：林建荣[1] 何凤贞[1] 赵德信[1] 温预关[1] 侯静[1] 陈国中[1] 

机构地区：[1]广州市精神病医院,广州510370

出　　处：《中国临床药理学杂志》2007年第1期6-9,共4页The Chinese Journal of Clinical Pharmacology

基　　金：广东省卫生厅科研基金资助项目(2002612)

摘　　要：目的研究氯氮平片和氯丙嗪片（均为抗精神分裂症药）对分裂症患者糖脂代谢和体质量的影响。方法于治疗前后对89例服氯氮平和83例服氯丙嗪患者做血糖、胰岛素、血脂和体质量测定及相关因素分析。结果用药90，180天，氯氮平组糖尿病发生率为7．9％及23．6％；而氯丙嗪组为1．1％及3．6％。2组90天时空腹和餐后2h血糖均升高，而180天时，继续升高（P〈0．01）。用药90天时，2组体质量较基线分别增高5．5％，4．8％；而180天分别增高9．1％，7．4％。2组胰岛素180天较基线明显增加有显著性差异（P〈0．01），组间无差别（P〉0．05）。2组胆固醇和甘油三脂均较基线明显增高（P〈0．01）。氯氮平组的血糖、胰岛素、血脂与体质量变化和血药浓度均有一定相关性（γ=0．21～0．99）。结论2种药对糖脂代谢和体质量均有作用，治疗期间要进行检测。Objective To study the influence of clozapine and chlor- promazine on body weight and glucose and lipid metabolism in patients with chronic schizophrenia. Methods Eighty nine patients treated with clozapine and 83 with chlorpromazine were recruited. Weight, blood glucose ,insulin, cholesterol and triglyceride were determined at the time of baseline,90,180 days after treatment. Results The incidence of diabetes mellitus after treatment of 90,180 days in clozapine group were 7.9% and 23.6% , respectively. While in chlorpromazine group were 1.1% and 3.6%. Compared with baseline, the level of blood glucose of fasting and 2 hours after meal in clozapoine and chlorpromazine were elevated after treatment of 90 days and even higher than after treanment of 180 days. The level of blood glucose in clozapine group is higher than that of an other group. After treatment of 90 days, the body weight increased by 5.5% ,9.1% in clozapine group, and 4.8% ,7.4% in chlorpromazine group. The level of insulin increased in two groups after treatment （P 〈 0.01 ） ,but there is no significant difference between the two groups（P 〉 0.05 ）. There are some COtTelations in the change of weight, blood glucose and insulin levels of blood concentration in clozapine group （γ= 0.21 - 0.99 ）. Conclusion The body weight and metabolism of glucose and lipid were effeted by clozapine and chlorpromazine in chronic schizophreniapatients. It is better to monitor these indexes.

关 键 词：精神分裂症 氯氮平片 氯丙嗪片 糖代谢 脂代谢 体质量 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R971.4[医药卫生—临床医学]