利培酮治疗精神分裂症疗效与代谢的相关性  

Relationship between the effect of risperidone on schizophrenia and metabolism

作　　者：陈大春[1] 李艳丽[1] 杨可冰[1] 王宁[1] 聂鹰[1] 谭云龙[2] 张向阳[2] 

机构地区：[1]北京回龙观医院二科,100096 [2]北京回龙观医院生物精神医学研究室

出　　处：《临床精神医学杂志》2009年第5期298-300,共3页Journal of Clinical Psychiatry

基　　金：美国斯坦利基金资助(03T-459;5T-726)

摘　　要：目的:评估利培酮治疗首发精神分裂症患者疗效与三酰甘油、总胆固醇、体质量变化的相关性。方法:符合美国精神障碍诊断与统计手册第4版诊断标准的首发精神分裂症住院患者80例,采用单一利培酮治疗,疗程12周,以阳性和阴性症状量表(PANSS)、临床疗效总评量表(CGI)、汉密尔顿抑郁量表(HAMD)评定临床疗效,并检测血三酰甘油、总胆固醇水平、体质量指数(BMI)。结果:与治疗前相比PANSS评分、CGI、HAMD量表评分显著降低,(t=12.2,6.2,13.8,υ=79,P均<0.05);三酰甘油、体质量、BMI与治疗前相比显著升高,(t=-3.1,-4.0,-4.5,υ=79,P均<0.05);PANSS总分及HAMD评分高减分组患者体质量增加值、BMI增加值显著大于低减分组(P均<0.05);阳性症状量表高减分组患者体质量增加值亦显著大于低减分组(t=-2.4,P<0.05);阴性症状分高减分组患者体质量增加值、总胆固醇增加值和BMI增加值亦显著大于低减分组(t=-3.1,-2.3,-3.5,P均<0.05);多元逐步回归分析显示治疗前后体质量增加值、总胆固醇增加值对阴性症状减分值的贡献率分别为11%和19%。结论:利培酮治疗引起体质量、血脂的变化与药物疗效存在着显著相关性。Objective： To evaluate the correlation of the effect of risperidone to first-episode schizophrenia and the change of glycerinate, cholesterol and body mass. Method：80 first-episode schizophrenia inpatients according to DSM-IV ,were treated only with risperidone,observed for 12 weeks,the clinical effects were estimated with the positive and negative syndrome scale （PANSS） and the c}inical gbbal impression scale （CGI）. The Hamilton depression scale （HAMD） and the concentrates of serum glycerinate and cholesterol as well as mass of body index （ BMI ） were tested. Results： Compared with the baselines, the scores of PANSS,CGI and HAMD had markedly decreased at week 12 （ t = 12. 2,6. 2,13.8, df = 79, P 〈 0.05 ）, glycerinate, BMI had significantly increased at weekl2（t = -3. 1, -4. 0, -4. 5 ,df=79,P 〈0.05）. The increase of body mass and BMI was more significant in the high reduction group than the low reduction group of PANSS and HAMD （ all P 〈 0. 05 ）. The increase of body mass was significantly more in high reduction group of possitive symptom than low reduction group（ t = -2.4, P 〈 0.05 ）, the change of body mass, total cholesterol and BMI significantly elevate in the high reduction group of negative symptoms than that in the low reduction group（t = -3.1, -2. 3, -3.5 ,P 〈 0.05 ）, multiple regression analysis suggests that the change of body mass and cholesterol accounted for 11% and 19% the variance changes of the reduction in negative symptom separately. Conclusion：The elevation of body mass and serum lipid are associated with the improvement symptom in subjects treated with risperidone.

关 键 词：精神分裂症 利培酮 血脂 体质量 

分 类 号：R749.3[医药卫生—神经病学与精神病学]