利培酮、阿立哌唑对女性精神分裂症腹部脂肪沉积的影响及瘦素的关系  

Effect of Risperidone and Aripiprazole on Abdominal Fat Deposition and the Relationship between Abdominal Fat Deposition and Serum Leptin

作　　者：金梅[1] 高志勤[1] 徐乐平[1] 金建烽 王志伟 

机构地区：[1]解放军第102医院精神科,中国常州213003 [2]武进第三人民医院精神科

出　　处：《中国健康心理学杂志》2014年第7期961-964,共4页China Journal of Health Psychology

摘　　要：目的探讨利培酮、阿立哌唑治疗后,女性精神分裂症患者腹部脂肪沉积的变化情况及其与血清瘦素水平的关系。方法首次治疗的女性精神分裂症患者随机分组,分别接受利培酮（n=26）、阿立哌唑（n=23）治疗,疗程8周。于基线、4周、8周时采用CT分别测定腹部内脏脂肪（VA）、皮下脂肪（SA）面积、内脏脂肪/皮下脂肪比值（VA/SA）,同时观察血清瘦素水平的变化情况。结果①利培酮组4,8周时VA（分别t=2.704、7.130,P〈0.05、0.001）、VA/SA（分别t=5.244、6.034,P均〈0.001）均较基线增高,8周时SA增高（t=3.132,P〈0.01）;阿立哌唑组VA、SA、VA/SA在4周、8周时的改变均不显著（P均＞0.05）;②利培酮组8周时瘦素水平较基线显著升高（t=2.838,P〈0.01）,4周时则无显著变化（P＞0.05）;阿立哌唑组4、8周时瘦素水平均较基线无显著变化（P均＞0.05）;③两组基线及4,8周时的瘦素水平均与SA正相关（r=0.414～0.535,P〈0.05～0.01）;利培酮组8周时的瘦素水平与VA/SA正相关（r=0.527,P〈0.01）。结论利培酮可致女性精神分裂症腹部脂肪沉积、以腹部内脏脂肪最为明显,并与瘦素的增高有关,而阿立哌唑对此影响较小。Objective To observe the effects of risperidone and aripiprazole on abdominal fat deposition and its relationship with ser -um leptin in female schizophrenic patients .Methods Female schizophrenic patients were randomly divided into two groups treated with risperidone（n=26）or aripiprazole（n=23）for 8 weeks.Abdominal visceral adipose（VA）,subcutaneous adipose（SA）,VA/SA ratio by computer tomography and serum leptin levels were determined at baseline and 4,8weekend .Results Significant increases in both VA （t=2.704,7.130,P〈0.05or 0.001）and VA/SA（t=5.244,6.034,P〈0.001）were identified after 4,8 weeks risperidone treatment, while the increase in SA was found to be significant only after 8 weeks treatment（t=3.132,P〈0.01）,There were no significant changes in VA,SA,VA/SA after aripiprazole treatment（P〉0.05）.The levels of serum leptin were significantly increased in risperidone group （t=2.838,P〈0.01） at 8 weekend,whereas not significantly increased at the end of 4,8 weeks compared with baseline （ P〉0.05） in aripiprazole group.The levels of leptin were positively related with SA （r=0.414～0.535,P〈0.05 or 0.01） at any time point of the study.The correlation between leptin and VA/SA at the end of 8 weeks in risperidone group was significant （r=0.527,P〈0.01）.Con-clusion Risperidone treatment may result in abnormal abdominal fat distribution especially visceral adipose which is associated with an augment of leptin in female schizophrenic patients ,however,aripiprazole may have hardly effects on them.

关 键 词：精神分裂症 阿立哌唑 利培酮 脂肪沉积 瘦素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]