阿立哌唑对首发精神分裂症患者代谢影响的对照研究  

Metabolic parameters in patients with first-episode schizophrenia treated with aripiprazole or olanzapine

作　　者：苏伟[1] 钱敏才[1] 沈鑫华[1] 杨剑虹[1] 李建华[1] 那万秋[1] 周虎江[1] 杨胜良[1] 

机构地区：[1]湖州市第三人民医院精神科,313000

出　　处：《浙江医学》2016年第10期707-710,共4页Zhejiang Medical Journal

摘　　要：目的 观察阿立哌唑对首发期精神分裂症患者的疗效、代谢及体重的影响.方法 将120例精神分裂症患者按随机数字表法分为阿立哌唑组60例和奥氮平组60例,阿立哌唑组予阿立哌唑口腔崩解片10～30mg/d,奥氮平组予奥氮平片10～20mg/d,对两组进行为期24周的开放性对照研究.于治疗前、治疗第2、4、8、24周末分别采用阳性与阴性症状量表（PANSS）进行评定疗效,并于治疗前、治疗4、8、24周末测定血清瘦素、脂联素、生长激素刺激肽、胰岛素及体重,观察不良反应发生情况.结果 至研究终点,阿立哌唑组总有效率为57.8％,奥氮平组总有效率为59.3％（P ＞0.05）.治疗后,阿立哌唑组和奥氮平组瘦素水平均有不同程度的升高,并与BMI呈正相关（r=0.541、0.287,P=0.000、0.042）.奥氮平组脂联素水平在治疗后降低,与24周末BMI呈负相关（r=-0.281,P=0.040）;阿立哌唑组无相关性（r=-0.256,P=0.078）.阿立哌唑组生长激素刺激肽水平降低,与24周末BMI负相关（r=-0.293,P=0.033）;奥氦平组无相关性（r=0.000,P=0.999）.奥氮平组胰岛素水平持续升高,与24周末BMI正相关（r=0.4121,P=0.006）,阿立哌唑组无相关性（r=0.038,P=0.738）.两组均未出现严重不良反应.结论 阿立哌唑治疗首发精神分裂症的疗效与奥氮平相当,对代谢及体重影响相对小.Objective To assess the metabolic parameters in patients with first-episode schizophrenia treated with aripiprazole or olanzapine.Methods One hundred and twenty patients with first-episode schizophrenics were randomly assigned to two groups：60 patients were treated with aripiprazole orally disintegrating tablets10～30mg/d （24.52 ± 4.39mg/d） for 24 wk （study group） and another 60 patients were treated with olanzapine tablets 10～20mg/d （17.96 ±3.44mg/d） for 24 wk （control group）.Positive and Negative Syndrome Scale （PANSS）,Treatment Emergent Symptom Scale （TESS） were applied for assessment before treatment and at the end of 2th,4th,8th and 24th week.Body weight was examined and Body Mass Index （BMI） was calculated.Serum metabolism related indicators were tested,including Leptin,Adiponectin,Ghrelin and Insulin.Results At the end point,the efficacy rate in study group and control group was 57.8％ and 59.3％,respectively （P ＞0.05）.After treatment,the leptin concentrations in two groups were increased in different degrees and were positively correlated with BMI （study group：r=0.541,P=0.000.control group：r=0.287,P=0.042.）.In the control group,the adiponectin concentrations were decreased after treatment and negatively correlated with MBI at the end of 24th week （r=-0.281,P=0.040）;the correlation was not observed in study group（r=-0.256,P=0.078）.The Ghrelin concentrations in the study group were decreased and negatively correlated MBI at the end of 24th week （r=-0.293,P=0.033）;there was no significant correlation in control group （r=0.000,P=0.999）.The Insulin concentrations in the control group were sustained increasing and positively correlated with MBI at the end of 24th week（r=0.421,P=0.006）;while no significant correlation was observed in study group（r=0.038,P=0.738）.There were no severe adverse reaction in both groups,and the incidence of adverse reactions was similar in two groups（P ＞0.05）.Conclusion The efficacy of aripiprazole on fir

关 键 词：阿立哌唑 精神分裂症 瘦素 脂联素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]