女性患者长期服用氯氮平及新型抗精神病药对糖脂代谢的影响  

Effects of long-term clozapine and new antipsychotics on glucose and lipid metabolism in females

作　　者：李振华 高琼[1] 胥杰[1] 金伟峰[1] 陈姝子 郭照宇 刘遵建[1] 孙佳琪[1] 方伟[1] 张磊[1] 林萍[1] 朱莉莉[1] LI Zhenhua;GAO Qiong;XU Jie;JIN Weifeng;CHEN Shuzi;GUO Zhaoyu;LIU Zhunjian;SUN Jiaqi;FANG Wei;ZHANG Lei;LIN Ping;ZHU Lili(Department of Clinical Laboratory,Shanghai Mental Health Center,Shanghai 200030,China)

机构地区：[1]上海市精神卫生中心检验科

出　　处：《国际检验医学杂志》2019年第14期1705-1708,共4页International Journal of Laboratory Medicine

基　　金：上海市精神卫生中心院级课题(2017-YJ-14);上海市精神卫生中心特色学科项目(2017-TSXK-07)

摘　　要：目的 观察长期服用氯氮平及新型抗精神病药对女性精神分裂症患者糖脂代谢的影响,为临床用药提供思路以提高临床用药安全性。方法 对2010-2016年51例女性精神分裂症患者血糖、胰岛素、糖化血红蛋白、三酰甘油、胆固醇、高密度脂蛋白、低密度脂蛋白、载脂蛋白A、载脂蛋白B糖脂代谢指标进行检测分析。探讨单用氯氮平(A组)、单用新型抗精神病药(B组)、氯氮平和新型抗精神病药联用(C组)对糖脂代谢指标的影响。结果 2010年胰岛素、胆固醇、低密度脂蛋白均值水平与2016年比较差异有统计学意义( t 1=-3.728 、 t 2=-3.047、 t 3=-7.449,均 P <0.05)。2010年A、B、C组低密度脂蛋白均值水平与2016年比较差异有统计学意义( P <0.05)。结论 长期服用抗精神病药物可引起女性糖脂代谢紊乱,从而增加各类并发症的风险,在临床用药选择时需慎重考虑药物可能存在的不良反应。Objective To observe the effects of long-term clozapine and new antipsychotics on glycometabolism and lipid metabolism in female patients with schizophrenia,and to provide some ideas for clinical to improve the safety of clinical medication. Methods From 2010 to 2016,blood glucose,insulin,glycosylated hemoglobin,triacylglycerin,cholesterol,high density lipoprotein,low density lipoprotein,apolipoprotein A,and apolipoprotein B were detected and analyzed in 51 female patients with schizophrenia.The effects of clozapine alone (group A),new antipsychotics alone (group B),clozapine combined with new antipsychotics (group C) on glucose and lipid metabolism were investigated. Results The mean levels of insulin,cholesterol and low density lipoprotein in 2010 were significantly different from those in 2016 ( t 1=-3.728, t 2=-3.047, t 3=-7.449 ,all P <0.05).There was statistically significant difference between the mean level of low density lipoprotein in group A,B and C in 2010 and that in 2016 ( P <0.05). Conclusion Long-term use of antipsychotic drugs can cause glucose and lipid metabolism disorders in females,increasing the risk of various complications.Therefore,the choice of clinical medication needs to be carefully considered as the possible adverse drug reactions.

关 键 词：氯氮平 抗精神病药 糖脂代谢 

分 类 号：R749.3[医药卫生—神经病学与精神病学]