利培酮与奥氮平对不同ApoE基因亚型精神分裂症患者血脂水平的影响  

Effects of risperidone and olanzapine on blood lipid levels in schizophrenic patients with different subtypes of ApoE gene

作　　者：萧鲲 张翠玲[2] 黄丽红[2] 卢志伟[3] 范敏珍[4] XIAO Kun;ZHANG Cui-ling;HUANG Li-hong;LU Zhi-wei;FAN Min-zhen(Department of PCCM,The Second People's Hospital of Baiyun District,Guangzhou 510370,China)

机构地区：[1]广州市白云区第二人民医院PCCM科,510370 [2]广州医科大学附属脑科医院门急诊科 [3]广州医科大学附属脑科医院神经内科 [4]广州医科大学附属脑科医院老年科

出　　处：《临床精神医学杂志》2021年第4期279-282,共4页Journal of Clinical Psychiatry

基　　金：广州市中医药和中西医结合科技项目(20192A010015);广州市卫生健康科技一般引导项目(20201A010031)。

摘　　要：目的:探讨利培酮和奥氮平与载脂蛋白(Apolipoprotein,ApoE)基因多态性在精神分裂症共患高脂血症发生发展中的相互作用。方法:纳入研究对象375例,采集一般资料、血脂谱及ApoE基因多态性等临床数据,基于“药物-性别-ApoE亚型”分组后进行统计分析。结果:奥氮平单药治疗者主要显现ApoE4亚型降低高密度脂蛋白(HDL)的效应,而利培酮单药治疗者主要显现ApoE2亚型降低血中总胆固醇(TC)、低密度脂蛋白(LDL)水平和升高HDL水平的效应,男性更加明显。结论:对于接受对脂代谢影响较小的第二代非典型抗精神病药(SGAs)治疗的精神分裂症患者,可能更需要进行ApoE亚型检测以指导调脂治疗;对于接受对脂代谢影响较大的SGAs治疗的精神分裂症患者,ApoE亚型可能不是其共患高脂血症的保护因素,更需要定期监测血脂水平。Objective:To investigate the interaction between risperidone,olanzapine and apolipoprotein(ApoE)gene polymorphisms in the development of hyperlipidemia in schizophrenia.Method:375 patients were included in the study and general data,blood lipid profile and ApoE gene polymorphism were collected.Statistical analysis was performed based on"Drug-Gender-ApoE subtype"group.Results:Olanzapine monotherapy showed that ApoE4 subtype decreased high density lipoprotein(HDL),while risperidone monotherapy showed that ApoE2 subtype decreased total cholesterol(TC),low density lipoprotein(LDL)and increased HDL level.The effects were more obvious in men.Conclusion:For schizophrenic patients receiving second-generation atypical drugs(SGAs)therapy which has little effect on lipid metabolism,ApoE subtype detection may be more necessary to guide lipid-lowering therapy;for schizophrenia patients receiving SGAs treatment which has a great impact on lipid metabolism,ApoE subtype will not be a protective factor of hyperlipidemia,and it may be more necessary to monitor the blood lipid level regularly.

关 键 词：利培酮 奥氮平 APOE基因多态性 精神分裂症 血脂 

分 类 号：R749.3[医药卫生—神经病学与精神病学]