氯氮平联合低剂量阿立哌唑对难治性精神分裂症患者体质量及糖脂代谢影响的随机、单盲、前瞻性研究  

Effects of clozapine combined with low dose aripipprazole on body weight and glycolipid metabolism in patients with treatment-resistant schizophrenia:a randomized,single blind,prospective clinical study

作　　者：李斌[1] 王赟[1] 贾静静[1] 奚巍[1] 

机构地区：[1]上海市杨浦区精神卫生中心,上海200093

出　　处：《四川精神卫生》2017年第4期328-332,共5页Sichuan Mental Health

摘　　要：目的探讨氯氮平联合低剂量阿立哌唑对难治性精神分裂症患者体质量及糖脂代谢的影响。方法于上海市杨浦区精神卫生中心选取符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准和难治性精神分裂症诊断标准的住院患者62例,采用随机数字表法分为研究组和对照组各31例。两组均给予氯氮平治疗,研究组在此基础上联合10mg阿立哌唑治疗,两组均治疗12周。于基线期和治疗第4、8、12周末采用阳性和阴性症状量表(PANSS)评定患者的精神症状,并对患者体质量、体质量指数、空腹血糖、餐后2h血糖、甘油三酯、总胆固醇进行测定。结果治疗第8、12周末,两组PANSS总评分与基线期比较差异均有统计学意义(P均<0.01),但组间比较差异无统计学意义(P>0.05)。治疗第12周末,研究组体质量、体质量指数、空腹血糖、总胆固醇与基线期比较差异无统计学意义(P>0.05),餐后2h血糖、甘油三脂与基线期比较差异有统计学意义(P<0.05);对照组总胆固醇与基线期比较差异无统计学意义(P>0.05),体质量、体质量指数、空腹血糖、餐后2h血糖、甘油三脂与基线期比较差异有统计学意义(P<0.05)。治疗第12周末,两组体质量和体质量指数、空腹血糖和餐后2h血糖、甘油三脂比较差异均有统计学意义(P均<0.05)。结论氯氮平联合低剂量阿立哌唑与单用氯氮平治疗均能改善难治性精神分裂症患者的精神症状,但联合治疗对患者体质量及糖脂代谢的影响相对较小。Objective To investigate the effects of clozapine combined with low dose aripiprazole on body weight, glucose and lipid metabolism in patients with refractory schizophrenia. Methods 62 cases of hospitalized patients who met the diagnostic criteria of the International Classification of Diseases, tenth edition （ICD - 10） and the diagnostic criteria for refractory schizophrenia were recruited in Shanghai Yangpu District Mental Health Center. The random number table was adopted to divided participants into the research group （n = 31 ） and the control group （ n = 31 ） . The research group was treated with clozapine combined with 10 mg aripipprazole while the control group was treated with clozapine monotherapy. All of them were treated for 12 weeks. The Positive and Negative Syndrome Scale （ PANSS） was used to assess thepsychiatric symptoms, and body weight, BMI, FBG, 2hPBG, TG and T-CH were measured at the baseline and the 4th ,8th, 12th weekend after treatment. Results At the 8th and 12th weekend, the total PANSS scores of both groups were significantly lower than the baseline （ P 〈 0. 01） , but there was no statistically significant difference between the two groups. Comparing the datas of the research group between the 12th weekend and the baseline period, there was no significant difference in body mass, BMI, FBG and TG （P 〉0. 05） , while there were significant differences in 2h PBG and TG （P 〈0. 05） . Meanwhile, analysing the datas of the control group between the 12th weekand the baseline period, there was no significant difference in T - CH（ P 〉0. 05 ） , while the body weight, BMI, FBG, 2h PBG and TG were significant different. At the end of the 12th weekend, there were statistically significant difference in body weight, BMI, FBG, 2h PBG and TG of the two groups（P 〈 0. 05）. Conclusion Both of clozapine combined with low dose aripiprazole and clozapine alone can improve the psychiatric symptoms of refractory schizophrenia patients

关 键 词：氯氮平 阿立哌唑 精神分裂症 体质量 糖脂代谢 

分 类 号：R749.3[医药卫生—神经病学与精神病学]