氯氮平、阿立哌唑对精神分裂症患者血浆神经肽Y、瘦素水平的影响及其与体质量变化的关系  

Effects of clozapine and aripiprazol on neuropeptide Y,leptin and body mass in schizophrenic patients

作　　者：陈琪[1] 徐乐平[1] 施辉[1] 李宁[1] 宋梓祥[1] 

机构地区：[1]江苏省常州市解放军第102医院,213003

出　　处：《临床精神医学杂志》2016年第3期171-174,共4页Journal of Clinical Psychiatry

摘　　要：目的:探讨氯氮平和阿立哌唑对精神分裂症患者血浆神经肽Y、瘦素水平的影响及其与体质量变化的关系。方法:60例精神分裂症患者随机分为氯氮平组和阿立哌唑组各30例,分别接受氯氮平和阿立哌唑治疗6周。于治疗前及治疗3周和6周后分别测定两组血浆神经肽Y、瘦素水平及体质量,并进行治疗前后的比较及回归分析。结果:重复测量方差分析显示,血浆神经肽Y、瘦素水平及体质量存在交互效应(F=11.203,P=0.000;F=5.981,P=0.033;F=7.523,P=0.003)和组别主效应(F=6.772,P=0.023;F=37.771,P=0.000;F=5.674,P=0.039)。治疗3周和6周时,氯氮平组血浆神经肽Y水平(F=30.764,P=0.000;F=59.963,P=0.000)、体质量(F=5.424,P=0.042;F=11.423,P=0.000)均高于治疗前;治疗6周时,血浆瘦素水平显著高于治疗前(F=10.132,P=0.004)。阿立哌唑组血浆神经肽Y(F=0.143,P=0.708;F=0.293,P=0.593)、瘦素水平(F=1.343,P=0.256;F=1.030,P=0.326)、体质量(F=2.743,P=0.113;F=0.132,P=0.722)与治疗前比较差异无统计学意义。逐步回归分析显示,治疗3周和6周时神经肽Y变化值可以解释同期体质量变化值变异的41.9%和21.8%。结论:与阿立哌唑比较,氯氮平可显著增加精神分裂症患者血浆神经肽Y、瘦素水平;神经肽Y水平增高可能是氯氮平导致患者体质量增加的内因之一。Objective： To analyze and compare the effects of clozapine and aripiprazol treatment on neuropeptide Y（ NPY）,leptin and body mass in schizophrenias. Method： Sixty schizophrenic patients were assigned to clozapine and aripiprazol treatment group respectively,30 patients for each group,and body neuropeptide Y,leptin and body mass of both groups were measured at baseline,weekend 3 and weekend 6. Results：There were significant interactions between groups and time in NPY,leptin and body weight（ F = 11. 203,P =0. 000; F = 5. 981,P = 0. 033; F = 7. 523,P = 0. 003）,and main effects of group（ F = 6. 772,P = 0. 023; F =37. 771,P = 0. 000; F = 5. 674,P = 0. 039）. Both plasma NPY（ F = 30. 764,P = 0. 000; F = 59. 963,P =0. 000） levels and the body mass（ F = 5. 424,P = 0. 042,F = 11. 423,P = 0. 000） in clozapine group at weekend3 and weekend 6 were significantly higher compared to the baseline,and leptin（ F = 10. 132,P = 0. 004） levels were significantly higher at weekend 6 compared to baseline. The differences of body weight（ F = 2. 743,P =0. 113; F = 0. 132,P = 0. 722） and plasma NPY（ F = 0. 143,P = 0. 708; F = 0. 293,P = 0. 593）,leptin（ F =1. 343,P = 0. 256; F = 1. 030,P = 0. 326） levels at each time point in aripiprazol group were not statistically significant compared to the baseline. Stepwise regression analysis showed plasma NPY change value entered regression equation when body weight change value as dependent variable,plasma NPY change value can explain 41. 9%variance in 3 nd weekend and 21. 8% variance in 6th weekend of body weight change value. Conclusion：Clozapine significantly increased body weight in schizophrenia patients compared with aripiprazol,and the change of neuropeptide Y may be one of the intrinsic causes of body weight increase of patients.

关 键 词：精神分裂症 氯氮平 阿立哌唑 神经肽Y 瘦素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]