二甲双胍对住院精神分裂症伴糖耐量减低患者干预的3年随访  

The preventive effect of metformin on schizophrenic inpatients with impaired glucose tolerance from becoming diabetes mellitus:a 3-year follow up study

作　　者：谢红涛[1] 张洪艳[1] 孙莉[1] 赵辉[1] 王祖承[2] 

机构地区：[1]上海市普陀区精神卫生中心,200065 [2]上海交通大学医学院附属精神卫生中心

出　　处：《临床精神医学杂志》2012年第4期232-235,共4页Journal of Clinical Psychiatry

摘　　要：目的:观察二甲双胍干预对糖耐量减低(IGT)的住院精神分裂症患者糖尿病发病率的作用。方法:对符合《中国2型糖尿病防治指南2007》诊断标准的78例IGT住院精神分裂症患者,随机分为对照组、饮食+运动组和二甲双胍组,每组26例,随访观察3年。结果:初访时3组基线资料无统计学差异。3年末,对照组糖尿病发生率为73.1%(19/26);饮食加运动组为45.5%(10/22);二甲双胍组为16.7%(4/24),组间存在统计学差异(χ2=15.998,P=0.000),二甲双胍组与对照组比较,存在统计学差异(χ2=15.987,P=0.000);二甲双胍组与饮食加运动组比较,存在统计学差异(χ2=4.493,P=0.034);饮食加运动组与对照组比较,无统计学差异(χ2=3.802,P=0.051)。二甲双胍组3年末糖化血红蛋白(GHbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)与饮食+运动组和对照组比较均存在统计学差异(P<0.05)。结论:二甲双胍与行为干预单一或联合治疗均对减轻精神分裂症患者IGT发展到糖尿病(DM)可能有一定效果,二甲双胍联合行为干预的疗效更好。Objective： To observe the effect of mefformin interventions on schizophrenic inpatients with impaired glucose tolerance （IGT）. Method：In this 3-year prospective study,78 subjects with IGT were in- cluded. The criteria of IGT was based on the prevention of type 2 diabetes in China Guide 2007. The subjects were divided into control（ C ）, diet plus exercise （ D ＋ E） and metformin （M） groups,26 subjects in each group. Results ：The baseline data of 3 groups had no statistical differences. By the end of study, the diabetes inci- dence was 73.1% （19/26） in group C,45.5% （10/22） in group D ＋ E and 16.7% （4/24） in group M. There was significant difference in 3 groups （ x2 = 15. 998, P = 0. 000）, and there was significant difference between group M and group C （ x2 = 15. 987, P = 0. 000） ; also between group M and group D ＋ E （ Xz = 4. 493, P = 0. 034 ） ; Metformin treatment was associated with improvement of fasting insulin, glycosylated hemoglobin and HOMA-IR were also decreased with significance difference compared with group C and group D ＋ E （P 〈 0.05）. Conclusion：Either of （or both） metformin and behavior intervention may prevent to a certain extent schizo- phrenic patients with IGT from diabetes mellitus,and both metformin （and） behavior have better efficacy.

关 键 词：精神分裂症 糖耐量减低 糖尿病 二甲双胍 

分 类 号：R749.3[医药卫生—神经病学与精神病学]