抗精神病药物对首发精神分裂症患者糖脂代谢和体重的影响  

Effects of antipsychotics on glucose and lipid metabolism and body weight of patients with first-episode schizophrenia

作　　者：贾杰[1] 王赞利[1] 钟意娟[1] 魏腊梅[1] 郭芝芳[1] 吕翠萍[1] 李界兴[1] 张辉[1] 

机构地区：[1]陕西省西安市精神卫生中心,西安710061

出　　处：《精神医学杂志》2009年第1期14-17,共4页Journal of Psychiatry

基　　金：西安市科技计划项目(编号:GG05141)

摘　　要：目的比较抗精神病药物对首发精神分裂症患者血糖、血脂及体重的影响,评价不同药物的安全性。方法对门诊/住院首发精神分裂症患者作为期一年药物治疗的随访观察,比较单一使用非典型抗精神病药(维思通、喹硫平、阿立哌唑)和典型抗精神病药(氯丙嗪)患者的空腹血糖、体重指数(BMI)、血脂的变化。结果完成一年随访患者179例,其中出现空腹血糖超标22例(12.3%),确诊糖尿病1例;新增高甘油三脂48例(26.8%)、高胆固醇31例(17.3%);单因素相关分析显示,血糖超标与体重指数、年龄、病程及高甘油三脂呈显著性相关,而与用药选择无显著性相关;各组药物对糖脂代谢均有影响,阿立哌唑对精神分裂症患者的体重、血糖、血脂影响最小;Logistic回归分析结果显示体重指数增加、病程长是血糖超标的危险因素。结论抗精神病药物对精神分裂症患者糖脂代谢、体重增加等方面均有不同程度的影响,应预测性评估、定期监测和提早干预。Objective rib compare the effects of antipsyehotics on glucose and lipid metabolism and body weight of patients with first--episode schizophrenia,and to evaluate the safety of antipsychotics. Methods To follow--up the patients with first--episode schizophrenia for 1 year periodically, comparing the varies of fasting plasma glucose（FVPG）, BMI and blood--lipid of patients taking atypical antipsychotic drugs （risperidone, quetiapine, aripiprazole） and typical anti psychotic drug （chlorpromazine）. Results 179 patients were followed - up for 1 year, 22 patients had higher FVPG（12.3%）exceeding the range,1 patient was diagnosed diabetes; 48 patients（26.8%） had high TG level and 31 had high blood cholesterol level. Single factor correlating analysis showed exceeding range of FVPG bad significant correlation with BMI,age,the course of disease and high TG, while having no significant correlation with choices of medication. All the antipsyehotics affected glucose and lipid metabolism,aripiprazole had the least effect on body weight,blood glucose and blood lipid. Logistic regression analysis showed the increasing of BMI and longer course of disease were the risk factors of exceeding range of blood glucose. Conclusion Antipsychotics have influence on the glucose and lipid metabolism and body weight of patients with schizophrenia, which should be evaluated earlier,measured periodically and interfered as soon as possible.

关 键 词：抗精神病药物 精神分裂症 糖脂代谢 体重 

分 类 号：R749.3[医药卫生—神经病学与精神病学]