齐拉西酮与奥氮平对精神分裂症患者体质量及代谢的影响  

Effects on body mass and metabolism of ziprasidone versus olanzapine in the treatment of schizophrenia

作　　者：孙润珠[1] 薛芬[1] 彭正午[1] 谭庆荣[1] 

机构地区：[1]第四军医大学西京医院,陕西西安710032

出　　处：《精神医学杂志》2012年第1期8-10,共3页Journal of Psychiatry

基　　金：国家自然科学基金(编号:30870886)

摘　　要：目的探讨齐拉西酮与奥氮平治疗精神分裂症前后体质量及代谢指标的变化。方法将78例精神分裂症患者随机分为齐拉西酮组(36例)与奥氮平组(42例),分别给予齐拉西酮120～160 mg/d、奥氮平15～20mg/d,在入组时及治疗第2、4、8、12周采用PANSS评定疗效;并且在治疗前及治疗4、8、12周末测量体质量、空腹血糖(FBS)及血脂。结果 (1)齐拉西酮组与奥氮平组治疗后各次PANSS总分均较治疗前有显著下降(P<0.05,P<0.01),但是两组之间无显著差异(P>0.05)。(2)治疗前两组体质量及代谢指标无显著差异。但奥氮平组治疗前后体质量及代谢指标变化明显,在治疗12周后,体质量、血糖及血脂明显高于齐拉西酮组(P<0.05,P<0.01)。在治疗12周后,齐拉西酮组高密度脂蛋白水平与治疗前存在显著性差异(P<0.05),体质量及其他代谢指标与治疗前相比均无显著差异(均P>0.05)。结论齐拉西酮与奥氮平对精神分裂症患者症状的疗效相当,但齐拉西酮较奥氮平引起代谢综合征的风险明显降低,更适合伴有代谢综合征的患者。Objective To explore the influence on body mass, glucose and lipid metabolism of ziprasidone versus olanzapine in the treatment of schizophrenia. Methods 78 patients with schizophrenia were randomized into ziprasidone group（36 cases treated with ziprasidone for 12 weeks with the dosage of 120 mg/d to 160 rag/d）and olanzapine group （42 cases treated with olanzapine for 12 weeks with the dosage of 15 mg/d to 20 rag/d）. Possitive and negative syndrom scale （PANSS） were used to evaluate efficacy at baseline and the 2nd,4th,8th, 12th weekend. Body mass, fasting blood glucose and blood fat were measured at baseline and the 4th, 8th, 12th weekend. Results （ 1 ） Compared with the baseline, scores of PANSS in both groups decreased significantly at each interview point （P 〈 0.05, P 〈 0. 01 ）. However, there was no significant difference between the two groups （P 〉 0.05 ）. （2） There was nosignificant difference in body mass and metabolism markers at the baseline between the two groups （ P 〉 0.05 ）. But the body mass, fasting blood glucose and lipid in olanzapine group differed significantly when compared with those at baseline. At the 12th weekend, body mass, fasting blood glucose and lipid in olanzapine were significantly higher than those in ziprasidone group （P 〈0.05 ,P 〈0.01 ）. The body mass, fasting blood glucose and lipid in ziprasidone group showed no significant differences except the high density lipoprotein （P 〈 0.05 ）. Conclusion Ziprasidone and olanzapine both have good efficacy in the treatment of schizophrenia. Ziprasidone has fewer effects on body mass and metabolism than olanzapine.

关 键 词：齐拉西酮 奥氮平 体质量 代谢指标 

分 类 号：R749.3[医药卫生—神经病学与精神病学]