不同非典型抗精神病药物对器质性精神障碍患者疗效及体质量、脂糖代谢的影响  

Effects of two kinds of atypical antipsychotics on curative effect,body mass,lipid and glucose metabolism in patients with organic mental disorders

作　　者：王玲[1] 吕红霞[1] 徐记芳 马卫娜 

机构地区：[1]河南省洛阳市精神卫生中心,洛阳471000

出　　处：《国际精神病学杂志》2017年第1期30-32,36,共4页Journal Of International Psychiatry

摘　　要：目的比较两种不同非典型抗精神病药物对器质性精神障碍患者疗效及体质量、脂糖代谢的影响。方法随机数字表格法将符合纳入标准的86例器质性精神障碍患者分为观察组与对照组,各43例,观察组采取利培酮治疗,对照组采取奥氮平治疗,比较两组临床疗效、不良反应、治疗前后体质量、血糖及血脂等指标。结果两组治疗总有效率比较无显著差异(P>0.05)。两组治疗3个月后LDL-C、Leptin、HOMA-IR较治疗前均明显上升(P<0.05),但两组组间比较差异无统计学意义(P>0.05)。对照组治疗3个月后体质量、FPG、2hFPG较治疗前均显著上升(P<0.05),而观察组治疗前后上述指标无显著差异(P>0.05)。观察组体重增加、嗜睡、失眠、催乳素升高发生率较对照组差异有统计学意义(P<0.05)。结论长期服用利培酮、奥氮平治疗器质性精神障碍疗效类似,在不良反应上各有侧重点,但相比奥氮平,利培酮长期服用对患者体质量、脂糖代谢指标影响小,建议首选利培酮治疗。Objective To comparatively analyze the effects of two kinds of atypical antipsyehotics on curative ef- fect, body mass, lipid and glucose metabolism in patients with organic mental disorders. Methods 86 cases of patients with organic mental disorders who met the inclusion criteria were randomized into observation group and control group by the random number table method, 43 cases in each group. The observation group was treated with risperidone while the control group was treated with olanzapine. The clinical curative effects, adverse reactions, body mass before and after treatment, blood glucose and blood lipid, etc. were compared between the two groups. Results There was no signifi- cant difference in total response rate between the two groups （P〉 0.05 ） . After 3 months of treatment, LDL-C, Leptin and HOMA-IR in the two groups were significantly higher than those before treatment （ P〈0.05 ）, but there were no significant differences between the two groups （P 〉 0.05 ） . The body mass, FPG and 2hFPG of the control group after 3 months of treatment were significantly higher than those before treatment （ P 〈 0.05 ） while there were no significant differences of indexes mentioned above in the observation group （P〉O.05） . The differences in the incidence rates of gaining weight, sleepiness, insomnia and elevated prolactin between the observation group and the control group were significant （P 〈 0.05 ） . Conclusion The effects of long-term application of risperidone and olanzapine in the treatment of organic mental disorders are similar while the emphasis on adverse reactions is different. However, compared with olanzapine, long-term use of risperidone has little influence on patients＇ body mass, lipid and glucose metabolism in- dexes. Thus, risperidone is preferred in treatment.

关 键 词：器质性精神障碍 非典型抗精神病药物 体质量 糖脂代谢 

分 类 号：R749.05[医药卫生—神经病学与精神病学]