精神分裂症患者代谢异常的病例对照研究  

Metabolic abnormality in patients with drug-naive schizophrenia:Case-control study

作　　者：吴小立[1] 文飞[2] 钟智勇[1] 陶炯[1] 

机构地区：[1]中山大学附属第三医院心理科,510630 [2]广州医学院第二附属医院心理科,510260

出　　处：《新医学》2011年第11期726-729,共4页Journal of New Medicine

基　　金：广东省科技计划项目(2009B080701080)

摘　　要：目的:探讨首次接受治疗的精神分裂症患者代谢异常情况及齐拉西酮对其可能的影响。方法:病例组为29例初诊精神分裂症患者,在自然观察状态下予以齐拉西酮单药治疗4周,治疗前后分别测定其身高、体质量、腰围、臀围、总胆固醇、甘油三酯、HDL、LDL、载脂蛋白AI(aPOAI)、载脂蛋白B100(aPOB100)、空腹血糖、空腹胰岛素及C肽,并计算胰岛素抵抗指数(IR)、腰臀比和BMI;另设健康对照组44名,于基线时同测上述指标。将病例组与健康对照组、病例组治疗前后各项代谢指标进行比较分析。结果:病例组腰臀比、空腹胰岛素、C肽及IR水平均高于健康对照组,而HDL、aPOAI水平低于健康对照组(P<0.05或P<0.01);病例组治疗后空腹血糖较治疗前降低。结论:精神分裂症患者本身可能已有糖脂代谢异常;非典型抗精神病药物齐拉西酮对精神分裂症患者血糖、血脂水平影响较小,有利于精神分裂症患者的长期治疗。Objective： To investigate the metabolic abnormality in patients with drug-naive schizophrenia and possible metabolic effect derived from ziprasidone. Methods： Oral ziprasidone treatment was carried out on 29 cases of drug-naive schizophrenia admitted patients 4 weeks under natural observational situation. The height, weight, waistline, hipline, total cholesterol, triglyceride, HDL, LDL, apolipoprotein A-1 （aPOA1）, apolipopro- tein B100（aPOB100） , fasting blood-glucose, fasting insulin and C-peptide were recorded before and after treatment. Meanwhile, insulin resistance（IR）, waist-hip ratio（WHR） and BMI were calculated. Forty-four healthy volunteers were enrolled as controls. Results： Significant increase of WHR, fasting insulin, C-peptide and IR were revealed in drug-naive schizophrenia patients, when comparing with those in control（ P 〈 0. 05 ）. However, significant reduction of HDL and aPOA1 were revealed in drug-naive schizophrenia patients （P 〈 0. 05 ）. Furthermore, significant alleviation of fasting blood-glucose was observed in drug-naive schizophrenia patients after therapy （ P 〈 0. 05 ）. Conclusion： Glucose and lipid metabolic abnormality may complicate with schizophrenia. Thus ziprasidone, which mildly affects the glucose and lipid metabolism, should be considered in long-term treatment of schizophrenia.

关 键 词：齐拉西酮 首次治疗 精神分裂症 病例对照 代谢异常 

分 类 号：R749.3[医药卫生—神经病学与精神病学]