氨磺必利或利培酮治疗首发精神分裂症患者的效果观察及对体质量、糖脂代谢、内分泌的影响  

Effect of Amisulpride or Risperidone in the Treatment of Patients with First-episode Schizophrenia and Its Influence on Body Mass Index, Glycolipid Metabolism and Endocrine Profile

作　　者：徐勇[1] 蒋志锋[1] 何泽民[2] 胡庭刚[1] XU Yong;JIANG Zhi-feng;HE Ze-min;HU Ting-gang(Department of Pharmacy,the Third People's Hospital of Panzhihua,Panzhihua,Sichuan 617061,China;Department of Pharmacy,the People's Hospital of Renhe District,Panzhihua,Sichuan 617061,China)

机构地区：[1]攀枝花市第三人民医院药剂科,四川攀枝花617061 [2]攀枝花市仁和区人民医院药剂科,四川攀枝花617061

出　　处：《临床误诊误治》2020年第1期25-30,共6页Clinical Misdiagnosis & Mistherapy

基　　金：四川省卫计委科研项目(16PJ211)

摘　　要：目的观察氨磺必利或利培酮治疗首发精神分裂症患者的效果及对体质量、糖脂代谢、内分泌的影响。方法选取2017年3月—2018年3月我院收治的120例首发精神分裂症患者,根据治疗方法的不同均分为氨磺必利组和利培酮组,疗程均为8周。比较两组治疗前及治疗8周后阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评分及治疗后总有效率,并且比较两组治疗前及治疗8周后体质量、糖脂代谢指标、内分泌指标变化。结果治疗8周后,两组PANSS阳性症状评分、一般病理症状评分、总分及治疗总有效率比较差异均无统计学意义(P>0.05),而氨磺必利组阴性症状评分明显低于利培酮组(P<0.01)。治疗8周后,氨磺必利组体质量指数、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)较治疗前均无明显改变(P>0.05),而利培酮组体质量指数、FBG、TC、TG较治疗前均明显升高(P<0.05或P<0.01),且明显高于氨磺必利组(P<0.05或P<0.01)。治疗8周后,两组泌乳素较治疗前均明显升高(P<0.01),且氨磺必利组低于利培酮组(P<0.01)。氨磺必利组治疗前后三碘甲状腺原氨酸(T 3)无明显改变(P>0.05),利培酮组治疗8周后T 3水平明显降低(P<0.01),且低于氨磺必利组(P<0.05)。结论氨磺必利与利培酮治疗首发精神分裂症总体疗效相当,但氨磺必利对患者阴性症状疗效更佳,且对体质量、糖脂代谢及内分泌影响较小。Objective To observe the effect of amisulpride or risperidone in the treatment of patients with first-episode schizophrenia(FES)and its influence on body mass index,glycolipid metabolism and endocrine profile.Methods A total of 120 patients with FES who were admitted to our hospital between March 2017 and March 2018 were selected.They were equally divided into the amisulpride group and the risperidone group according to different treatment methods.The course of treatment for both groups was 8 weeks.The scores of positive and negative syndrome scale(PANSS)before treatment and at 8 weeks after treatment,and the total response rate were compared between the two groups.Changes of body mass,glycolipid metabolism indexes and endocrine indexes before treatment and at 8 weeks after treatment were also compared between the two groups.Results At 8 weeks after treatment,there were no significant differences in positive symptom score,general pathological symptom score or total score of PANSS or response rate between the two groups(P>0.05),but the negative symptom score of the amisulpride group was lower than that of the risperidone group(P<0.01).At 8 weeks after treatment,there were no obvious changes in body mass index,fasting blood glucose(FBG),total cholesterol(TC)or triglyceride(TG)in the amisulpride group after treatment compared with those before treatment(P>0.05).However,the above-mentioned indexes in the risperidone group were significantly increased after treatment(P<0.05 or P<0.01),which were significantly higher than those in the amisulpride group(P<0.05 or P<0.01).At 8 weeks after treatment,the prolactin levels in both groups after treatment were significantly higher than those before treatment(P<0.01),and the level in amisulpride group was lower than that in risperidone group(P<0.01).There was no significant change in triiodothyronine(T 3)in the amisulpride group before and after treatment(P>0.05),while the level of T 3 in the risperidone group was decreased significantly at 8 weeks after treatment(P<0.01),which

关 键 词：精神分裂症 氨磺必利 利培酮 体质量 空腹血糖 血脂 

分 类 号：R749.3[医药卫生—神经病学与精神病学]