阿立哌唑联合奥氮平对体重超重精神分裂症患者糖脂代谢及成纤维细胞生长因子21的影响  

Effects of Aripiprazole Combined with Olanzapine on Glycolipid Metabolism and Fibroblast Growth Factor 21 in Schizophrenic Patients with Overweight

作　　者：郑昊[1] 黄敏 褚强强 ZHENG Hao;HUANG Min;CHU Qiangqiang(Department of Pharmacy,Anqing Psychiatric Hospital,Anqing 246000,China)

机构地区：[1]安庆市精神病医院药剂科,安庆246000 [2]合肥市第一人民医院全科医学科

出　　处：《国际精神病学杂志》2021年第2期224-228,共5页Journal Of International Psychiatry

基　　金：中国药学会科技开发中心科普项目(编号:CMEI2020KPYJ(JZX)00211);合肥市第六周期医学重点学科专项基金(编号:合卫科教[2019] 110)。

摘　　要：目的探讨阿立哌唑联合奥氮平对体重超重精神分裂症患者疗效、糖脂代谢及成纤维细胞生长因子21的影响。方法选取2017年6月~2019年6月我院收治的体重超重精神分裂症患者,其中对照组(44例),研究组(45例),对照组采用奥氮平口服治疗,初始剂量为5mg/d,在治疗2~3周内逐渐将奥氮平剂量增加至10~20 mg/d,但剂量不超过20mg/d。研究组采用在奥氮平治疗基础上联合阿立哌唑口服治疗,初始剂量为5 mg/d,在治疗2~3周内逐渐将阿立哌唑增加至20 mg/d,奥氮平减量至5mg/d。两组患者疗程均为12周。比较2组患者治疗前后临床症状、血糖血脂水平、BMI指数、FGF-21变化情况,并对FGF-21与上述代谢指标进行相关性分析。结果治疗后2组阳性和阴性症状量表(PANSS)各项评分均较治疗前降低,其中研究组各项评分较对照组降低,差异具有统计学意义(P<0.05),治疗后,对照组患者FPG、FGF-21水平、BMI指数、TC、TG、LDL-C水平较治疗前升高,差异均具有统计学意义(P<0.05),研究组患者上述指标与治疗前相比,差异无统计学意义(P>0.05),采用Pearson相关分析,结果显示对照组患者FGF-21变化水平与FPG、BMI、TC、TG、 LDL-C变化水平呈正相关。结论阿立哌唑联合奥氮平治疗体重超重精神分裂症,有利于患者糖脂代谢、BMI指数、FGF-21水平处于稳定状态,对患者临床症状评分具有改善作用。Objective To investigate the effects of aripiprazole combined with olanzapine on the glycolipid metabolism and fibroblast growth factor 21 in schizophrenic patients with overweight. Methods Schizophrenic patients with overweight who were admitted to our hospital from 2017 June to month 2019 June were selected,including the control group(44 cases)and the study group(45 cases). The control group was treated orally with olanzapine at an initial dose of 5 mg/d,and the dose was gradually increased to 10-20 mg/d within 2-3 weeks of treatment but not exceeded 20 mg/d. The study group adopted the oral administration of olanzapine combined with aripiprazole at a initial dose of 5 mg/d,and the dose of aripiprazole was gradually increased to 20 mg/d while olanzapine reduced to 5 mg/d within 2-3 weeks. Both groups were treated for 12 weeks. Then,we compared the changes of clinical symptoms,blood glucose and lipid levels,BMI and FGF-21 levels in the two groups before and after treatment and analyzed the correlation between FGF-21 and the above metabolic indexes. Results All positive and negative syndrome scale(PANSS)scores in the two groups were lower after treatment than before treatment,and all scores in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05). After treatment,the levels of FPG and FGF-21,BMI,the levels of TC,TG and LDL-C in the control group were higher than those before treatment,and the differences were statistically significant(P<0.05). There was no statistically significant difference of the above indexes in the study group after and before treatment(P>0.05). Pearson correlation analysis showed that the changes in FGF-21 in the control group were positively correlated with the changes in FPG,BMI,TC,TG and LDL-C. Conclusion Aripiprazole combined with olanzapine in the treatment of schizophrenia with overweight can promote glucose and lipid metabolism,BMI and FGF-21 level to be in a stable state as well as improving the clinical symptom scores

关 键 词：阿立哌唑 奥氮平 体重超重 精神分裂症 成纤维细胞生长因子21 

分 类 号：R749.053[医药卫生—神经病学与精神病学]