阿立哌唑与奥氮平对首发精神分裂症患者临床疗效及糖脂代谢的影响  

Effects of aripiprazole versus olanzapine on glucose and lipid metabolism in first-episode of schizophrenics

作　　者：徐健康[1] 刘旭[2] 赵路斌[1] 吕红霞[1] 王长虹[1,2] 

机构地区：[1]洛阳市精神卫生中心精神科,河南洛阳471013 [2]新乡医学院第二附属医院精神科,河南新乡453002

出　　处：《河南医学研究》2013年第2期183-187,共5页Henan Medical Research

摘　　要：目的:探讨阿立哌唑与奥氮平对首发精神分裂症患者临床疗效及糖脂代谢的影响。方法:将120例首发精神分裂症患者随机分为两组,每组60例,治疗组口服阿立哌唑治疗,对照组口服奥氮平治疗,观察8周。于治疗前及治疗8周末采用阳性与阴性症状量表评定临床疗效,检测两组血糖、血脂水平及体质量。结果:治疗2周末起,两组阳性与阴性症状量表总分及各因子分均较治疗前有显著下降(P<0.01),同期两组评分比较差异均无统计学意义(P>0.05)。治疗8周末,治疗组各项代谢指标与治疗前比较均无显著变化(P>0.05),对照组仅HDL与治疗前比较无显著变化外(P>0.05),其他各项代谢指标均较治疗前显著升高(P<0.01);治疗组三酰甘油、总胆固醇、低密度脂蛋白、空腹血糖、空腹胰岛素、胰岛素抵抗指数均显著低于对照组(P<0.01);治疗组体质量增加>7.0%者占13.3%,对照组为53.3%,治疗组显著低于对照组(χ2=21.60,P<0.01)。结论:阿立哌唑与奥氮平均能显著改善精神分裂症患者的各种精神症状,但奥氮平对患者的血糖、血脂代谢及体质量有显著影响,而阿立哌唑则无明显影响。Objective： To explore the effects of aripiprazole versus olanzapine on glucose and lipid metabolism in first-episode of schizophrenics. Methods ： 120 first-episode schizophrenics were ran- domly assigned to two groups of 60 cases each, treatment group taking orally aripiprazole and con- trol group with olanzapine for 8 weeks. Clinical efficacies were assessed based on Positive and Neg- ative Syndrome Scale （PANSS） before treatment and at the end of the 8th week. Blood glucose, blood fat and body mass were detected simultaneously. Results： At the end of the 2th week,the to- tal and each factor scores of PANSS of both groups lowered more significantly compared with pre- treatment （ P 〈 0.01 ） , contemporaneous group comparisons had no significant differences （P 〉 0.05）. At the end of the 8th week,there was no significant difference in all metabolic parameters compared with pretreatment in treatment group （P 〉 0.05） ; there was no significant difference in HDL and other metabolic parameters were significantly higher than pretreatment in control group（P 〈 0.01 ） ; triacylglycerol, cholesterol, LDL, fasting blood glucose, fasting insulin and insulin resistance index of treatment group were all significantly lower research than in control group （P 〈 0.01 ） ; patients with 〉 7.0% of weight gain were significantly fewer in research than in control group （ 13.3% vs 53.3% , X2 = 21.60 ,P 〈 0.01 ） . Conclusion ： Both aripiprazole and olanzapine could improve various kinds of symptoms of schizophrenics, but the latter has notable effects on blood glucose, lipid metabolism and body mass, the former has no.

关 键 词：精神分裂症 阿立哌唑 奥氮平 血糖 血脂 体质量 体质量指数 

分 类 号：R971.4[医药卫生—药品]