氯氮平和齐拉西酮对精神分裂症患者体质量、血浆神经肽Y及瘦素影响的研究  

Effect of clozapine and ziprasidone on body weight,neuropeptide Y and leptin of schizophrenia patients

作　　者：陈琪 施辉[2] 戴立彬 程祺 李宁 徐乐平 宋梓祥 

机构地区：[1]解放军102医院精神二科,江苏常州213003 [2]解放军113医院118临床部,浙江温州325000 [3]解放军102医院少儿行为医学科,江苏常州213003

出　　处：《东南国防医药》2016年第2期142-144,150,共4页Military Medical Journal of Southeast China

摘　　要：目的分析比较氯氮平和齐拉西酮对精神分裂症患者体质量、血浆神经肽Y及瘦素的影响。方法采用随机数表法,将60例符合《中国精神障碍分类与诊断标准》第3版诊断标准的精神分裂症患者分为氯氮平组和齐拉西酮组,每组各30例,分别接受氯氮平和齐拉西酮治疗,于治疗前、治疗第3、6周末,测定2组的体质量、血浆神经肽Y和瘦素水平。结果1氯氮平组治疗第3、6周末体质量和神经肽Y水平均显著高于治疗前,治疗第6周末瘦素水平显著高于治疗前(均P<0.05);齐拉西酮组治疗第3、6周末体质量、神经肽Y和瘦素水平与治疗前比较差异无统计学意义(P>0.05);2氯氮平组和齐拉西酮组体质量、神经肽Y和瘦素水平在组别×时间上存在明显的交互作用;3氯氮平组治疗3周和6周末体质量的变化(△体质量)与神经肽Y的变化(△神经肽Y)呈明显正相关(r分别为0.662与0.495,均P<0.05);4逐步回归分析显示,氯氮平组△神经肽Y进入以△体质量为因变量的回归方程,3周末△神经肽Y可以解释△体质量变异的41.9%,6周末△神经肽Y仍可以解释△体质量变异的21.8%。结论与齐拉西酮比较,氯氮平显著增加了精神分裂症患者的体质量,而神经肽Y的变化可能是氯氮平导致精神分裂症患者体质量增加的机制之一。Objective To analyze and compare the effect of clozapine and ziprasidone treatment on body weight,neuropeptide Y and leptin in schizophrenics. Methods 60 patients who were eligible for the Classification and Diagnostic Criteria of Mental Disorders in China（ 3rd edition） were assigned to Clozapine and Ziprasidone treatment group respectively（ 30 patients for each group）.Body weight,neuropeptide Y and leptin level of both groups were measured at baseline,weekend 3 and weekend 6. Results 1Both the body weight and plasma NPY level in clozapine group at weekend 3 and weekend 6 were significantly higher compared to the baseline,and leptin level was significantly higher at weekend 6 compared to baseline（ P〉0. 05）. The difference of body weight and plasma NPY,leptin level at each time point in ziprasidone group were not statistically significant compared to the baseline（ P〉0. 05）. 2There was significant interaction between groups and time of body weight,NPY,and leptin level in two groups. 3In clozapine group,the altering rate of body weight（ △body weight） at weekend 3 and weekend 6 was positively correlated with that of NPY（ △NPY） level（ r = 0. 662,P〈0. 05; r = 0. 495,P〈0. 05）. 4Stepwise regression analysis showed △plasma NPY of clozapine group entered to regression equation which the △body weight as dependent variable,and △plasma NPY can explain △body weight variance of 41. 9%in 3 weekend,21. 8% in 6 weekend. Conclusion Clozapine significantly increases body weight in schizophrenia patients compared with Ziprasidone,and the change of neuropeptide Y may be the intrinsic cause of body weight increasing of patients.

关 键 词：氯氮平 齐拉西酮 神经肽Y 瘦素 精神分裂症 

分 类 号：R749.3[医药卫生—神经病学与精神病学]