二甲双胍对奥氮平致精神分裂症肥胖患者肝脏脂肪含量的影响  

The Change of Liver Fat Content and Visfatin in Metformin-treated Schizophrenia with Olanzapine-induced Weight Gain

作　　者：纪菊英[1] 刘羽[1] 徐乐平[1] 汪莉[1] 高志斌[2] 

机构地区：[1]中国人民解放军第102医院精神科,江苏常州 [2]解放军第102医院放射科

出　　处：《中国健康心理学杂志》2017年第5期655-660,共6页China Journal of Health Psychology

摘　　要：目的:对奥氮平所致精神分裂症肥胖患者在接受二甲双胍治疗过程中,肝脏脂肪含量及血清内脏脂肪素的变化情况进行动态观察,并分析两者间的相互关系。方法:奥氮平治疗过程中出现肥胖的精神分裂症采用随机数字表法分为2组,分别接受二甲双胍(二甲双胍组,n=30)或安慰剂(安慰剂组,n=30)治疗,疗程12周。在治疗0周、12周时,分别测定肝脏脂肪含量、内脏脂肪素水平。结果:1治疗后12周时,二甲双胍组患者在肝脏脂肪含量显著下降(t=2.098,P<0.05)的同时,内脏脂肪素也显著降低(t=2.832,P<0.01);安慰剂组肝脏脂肪含量和内脏脂肪素的变化均不显著(P>0.05);2二甲双胍组治疗前后肝脏脂肪含量、内脏脂肪素的下降值,均显著高于安慰剂组(t=6.204、3.403;P均<0.001);3线性相关分析显示,二甲双胍组治疗前后肝脏脂肪含量的下降值与内脏脂肪素的下降值正相关(r=0.388,P<0.05)。结论:二甲双胍可降低奥氮平致精神分裂症肥胖患者肝脏脂肪含量及内脏脂肪素水平,内脏脂肪素的下降可能参与了二甲双胍的降低患者肝脏脂肪含量的作用机制。Objective：To observe the effect of metformin on 1iver fat content and visfatin in schizophrenia patients with olanzapin—induced weight gain and analyze the relationships between them.Methods：Schizophrenia patients with olanzapine—induced weight gain were randomized assigned to receive metformin（metformin group,n=30）or placebo（placebo group,n=30）treatment for 12 weeks.The 1iver fat content and serum visfatin were measured at baseline and the end of study.Results：Significantly decreased 1iver fat content（t=2.098,P〈0.05）and serum visfatin （t=2.832,P〈0.01）were observed in metformin group after 12 weeks treatment and no significantly changed 1iver fat content and visfatin were found in placebo group （P〉0.05）.The lowing of 1iver fat content and visfatin showed more significant change in metformin group than that in placebo group （t=6.204,3.403;P〈0.001）.The changes of 1iver fat content and serum visfatin had positive correlations（r=0.388,P〈0.05）in metformin group.Conclusion：Metformin may have effects on 1 iver fat content and serum visfatin in schizophrenia patients with olanzapine—in-duced weight gain.The latter should be one of mechanism of its improvement on 1iver fat content.

关 键 词：精神分裂症 二甲双胍 奥氮平 肝脏脂肪含量 内脏脂肪素 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R749.053[医药卫生—临床医学]