利培酮与奥氮平治疗精神分裂症对其肝脏B超结果及血脂代谢的影响  

Effects of risperidone and olanzapine on hepatic B-ultrasound findings and blood lipid metabolismin treatment of schizophrenia

作　　者：王冬雪[1] 朱胜保 张琦[3] Wang Dongxue;Zhu Shengbao;Zhang Qi(B-Ultrasound Room, Imaging Department, the Third Mental Health Center of Shanghai Civil Affairs, Shanghai 200000, China)

机构地区：[1]上海市民政第三精神卫生中心影像科B超室,200000 [2]上海利群医院肾内科 [3]上海市民政第三精神卫生中心检验科,200000

出　　处：《中国药物与临床》2019年第2期217-219,共3页Chinese Remedies & Clinics

摘　　要：目的探讨利培酮与奥氮平治疗精神分裂症对其肝脏B超结果及血脂代谢的影响。方法选取2013年1月到2017年12月在上海市民政第三精神卫生中心治疗的1 100例精神分裂症患者和上海利群医院550名同期健康人群(对照组)为研究对象,比较3组人群肝脏B超结果及其血脂代谢变化情况。结果奥氮平组与利培酮组在脂肪肝检出率上高于对照组(20.4%,16.2%,6.4%,P<0.05),奥氮平组与利培酮组在血脂增高检出率上高于对照组(18.0%,10.2%,3.6%,P<0.05),而奥氮平组较利培酮组和对照组在脂肪肝及血脂增高检出率差异有统计学意义(P<0.05)。奥氮平组中病程≥5年和中老年55～65岁脂肪肝检出率分别为12.5%和12.2%,高于利培酮组(P<0.05)。结论长期服用奥氮平的精神分裂症患者脂肪肝和血脂增高概率大大增加,需要定期进行肝脏彩色多普勒超声检查,规避药源性肝损伤的出现。Objective To investigate the effects of risperidone and olanzapine on hepatic B-ultrasound findings and blood lipid metabolism in the treatment of schizophrenia. Methods A total of 1 100 patients with schizophrenia admitted to the Third Mental Health Center of Shanghai Civil Affairs between January 2013 and December 2017, and a contemporary cohort of 550 healthy controls(control group) admitted to Shanghai Liqun Hospital were included as the subjects in the study. The changes in the B-ultrasound findings and blood lipid metabolism among the three groups were compared. Results The detection rate of fatty liver in the olanzapine group and risperidone group was higher than that in the control group(20.4%, 16.2%, 6.4%, P<0.05).The detection rate of hyperlipidemia in the olanzapine group and risperidone group was higher than that in the control group(18.0%, 10.2%, 3.6%, P<0.05).There were statistically significant difference in the detection rates of fatty liver and hyperlipidemia between the olanzapine group and the risperidone group and control group(P<0.05).In the olanzapine group, the detection rate of fatty liver in the course of disease≥5 years group and 55-65 years old middle-aged group was 12.2% and 12.5%, respectively, which was higher than that in the risperidone group(P<0.05). Conclusion The risk of fatty liver and hyperlipidemia increase greatly in patients with schizophrenia on long-term treatment with olanzapine. Patients with schizophrenia on long-term treatment with olanzapine need regular liver color Doppler examination to monitor for occurrence of drug-induced liver damage.

关 键 词：精神分裂症 利培酮 肝脏 血脂代谢 

分 类 号：R749.3[医药卫生—神经病学与精神病学]