阿立哌唑替代奥氮平对精神分裂症患者疗效和体重的影响  

Effects of switching from Olanzapine to Aripiprazole on weight gain and efficacy

作　　者：刘力[1] 刘盈[1] 范学胜[1] 王曼[1] 

机构地区：[1]中国医科大学附属第一医院精神医学科,辽宁沈阳110001

出　　处：《中国现代医学杂志》2008年第17期2517-2519,共3页China Journal of Modern Medicine

摘　　要：目的探讨对服用奥氮平引起体重明显增加,且精神症状处于稳定期的精神分裂症患者,用阿立哌唑逐步替代奥氮平,观察其对治疗有效性、体重和安全性的影响。方法对24例服用奥氮平处于精神症状稳定期(PANSS<60分),并且体重增加>20%或体质量指数(BMI)>25.0kg/m2的精神分裂症患者,在4周内完全替换成阿立哌唑,并继续服用该药12周。临床评估包括:体重变化、体质量指数、采用阳性与阴性症状量表(PANSS)评定疗效、副反应量表(TESS)评定药物不良反应及有关代谢方面的实验室检测。结果用阿立哌唑替代奥氮平后,在体重、体质量指数(BMI)、腰围、空腹血糖(FBG)及总胆固醇(TG)与替换前差异均有显著性(P<0.01或P<0.05),而PANSS总分、TESS分及其他代谢指标与替换前无明显差异。结论应用阿立哌唑替代奥氮平,是控制奥氮平引起体重增加及代谢障碍的一个有效对策。[Objective] To explore the effect of switching patients who had gained excessive weight and stable psychiatry on Olanzapine to Aripiprazole, with assessments of safety and continued efficacy as well as weight change. [Methods] 24 patients who psychiatrically stable on Olanzapine （PANSS〈60） but had gained t〉20% in weight or had body mass index 〉t25.0 kg/m-＂ were switched to Aripiprazole over a 4-week period and followed for 12 weeks, the total study duration being 16 weeks. Clinical assessments included weight change, BMI, antipsychotie efficacy using the Positive and Negative Symptom Syndrome Scale （PANSS）, adverse events using the TESS Scale, and labo- ratory studies for metabolic measures. [Results] There were significant changes in weight loss, body mass index （BMI）, waist circumference, fasting blood glucose （FBG）, and total cholesterol fiG） after switching from Olanzapine to Aripiprazole for 16 weeks （P 〈0.01 or P 〈0.05）. There were no significant changes in PANSS total scores, TESS scores or the other metabolic parameters. [Conclusion] Switching patients to Aripiprazole, appears to be a effective strategy for managing Olanzapine induced weight gain and metabolic disorder.

关 键 词：阿立哌唑 精神分裂症 体重增加 奥氮平 

分 类 号：R749.3[医药卫生—神经病学与精神病学]