抗精神病药对代谢的影响比较  

The Comparison of metabolic effects of antipsychotic drugs

作　　者：汪卫华[1] 赵汉清[1] 王焕林[1] 崔庶[1] 汪广剑[1] 仲爱芳[2] 宋梓祥[1] 闫同军[1] 薛蕴庄 

机构地区：[1]解放军第102医院精神科,常州213003 [2]解放军第102医院化验科,常州213003

出　　处：《临床精神医学杂志》2009年第1期55-57,共3页Journal of Clinical Psychiatry

摘　　要：目的:探讨抗精神病药对体质量、血糖、血脂、胰岛素、瘦素的影响。方法:首发住院精神分裂症患者94例随机分为3组,分别服用氯氮平、利培酮、奥氮平治疗,于治疗前和治疗6周测定体质量、血清瘦素、胰岛素、胰岛素抗体、空腹血糖、糖化血红蛋白(HbA1c)、血清胆固醇(TC)及三酰甘油(TG)。结果:3组治疗前后BMI变化分别为(2.37±2.11)kg/m2、(1.32±1.77)kg/m2、(2.07±1.38)kg/m2(F=10.783,P=0.000)。治疗前3组糖化血红蛋白差异显著(F=16.412,P<0.001),初始血糖、初始TC、TG、胰岛素、瘦素水平差异无显著性(P>0.05)。治疗6周后,3组间血糖、初始TC、TG、胰岛素、瘦素水平均有显著性差异。结论:氯氮平对体质量、血糖、血脂、瘦素及胰岛素的影响大;奥氮平不良反应较小,对体质量、血脂、血浆瘦素水平影响较大;利培酮对各项代谢指标及体质量的影响较小。Objective ：To explore the effects of antipsychotic drugs on patients body weight, leptin, insulin, fasting plasma glucose and triglyceride. Method：94 first-episode schizophrenia inpatients were recruited, treated by clozapine, risperidone and olanzapine in three groups. The body weight, serum leptin, insulin, insulin antibody, fasting plasma glucose, glycosylated hemoglobin （ HbAlc ）, total cholesterol （ TC ） and triglyceride（TG） were examined before treatment and after 6 week treatment respectively. Results：The body weight index （BMI） of clozapine, risperidone and olanzapine group increased by （2.37 ± 2.11 ） kg/m2, （ 1.32 ± 1.77） kg/m2 and （2.07 ± 1.38） kg/m2（ F = 10. 783 ,P =0.000）. Before the treatment the three groups did not show significant difference in fasting plasma glucose, TC, TG, insulin and serum leptin（P 〉0.05） but in the glycosylated hemoglobin（ F = 16. 412 ,P 〈0.001 ）. After 6 week treatment, the three groups showed significant differences in fasting plasma glucose, TC, TG, insulin and serum leptin. Conclusion ： Clozapine has influences on body weight blood glucose, blood fat, leptin, insulin. Olanzapine has influences on body weight,blood fat and leptin with light side effects. Risperdal has lighter influences on various kinds of the metabolism indicator and body weight.

关 键 词：抗精神病药 精神分裂症 体质量增加 瘦素 胰岛素 

分 类 号：R749.053[医药卫生—神经病学与精神病学]