氯氮平结合阿立哌唑治疗难治性精神分裂症的效果及对糖脂代谢和胰岛素抵抗的影响  

Effect of clozapine combined with aripiprazole in the treatment of refractory schizophrenia and its influence on glucose and lipid metabolism and insulin resistance

作　　者：齐龙涛 QI Long-tao(Department of Psychiatry,Third Affiliated Hospital of Shenyang Medical College(Shenyang 242 Hospital),Shenyang 110034,China)

机构地区：[1]沈阳医学院附属三院(沈阳二四二医院)精神心理科,110034

出　　处：《中国现代药物应用》2021年第23期147-150,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 探究氯氮平结合阿立哌唑治疗难治性精神分裂症的效果及对糖脂代谢和胰岛素抵抗的影响。方法 242例难治性精神分裂症患者,以随机数字表法分为对照组与研究组,各121例。对照组使用氯氮平治疗,研究组使用氯氮平+阿立哌唑治疗。比较两组临床疗效,用药前及用药1个月后的糖脂代谢指标、胰岛素抵抗指数。结果 研究组治疗总有效率90.08%高于对照组的70.25%,差异有统计学意义(P<0.05)。用药1个月后,两组空腹血糖、低密度脂蛋白胆固醇、总胆固醇、甘油三酯均较治疗前升高,但研究组低于对照组,差异有统计学意义(P<0.05)。用药1个月后,两组胰岛素抵抗指数均较治疗前升高,但研究组(1.65±0.39)低于对照组的(1.97±0.51),差异有统计学意义(P<0.05)。结论 联合用药方案可明显改善难治性精神分裂症患者病情,且对糖脂代谢、胰岛素抵抗指数的负面影响小,因此认为氯氮平、阿立哌唑的联合用药方案既有效又可行。Objective To investigate the effect of clozapine combined with aripiprazole in the treatment of refractory schizophrenia and its influence on glucose and lipid metabolism and insulin resistance.Methods A total of 242 patients with refractory schizophrenia were divided into control group and research group by random numerical table,with 121 cases in each group.The control group was treated with clozapine,and the research group was treated with clozapine and aripiprazole.Both groups were compared in terms of clinical efficacy,glucose and lipid metabolism and insulin resistance index before medication and 1 month after medication.Results The total effective rate of treatment 90.08%in the research group was higher than 70.25%in the control group,and the difference was statistically significant(P<0.05).1 month after medication,the fasting blood glucose,low-density lipoprotein cholesterol,total cholesterol,and triglycerides of the two groups were higher than those of this group before medication,but the research group was lower than the control group,and the difference was statistically significant(P<0.05).1 month after medication,the insulin resistance index of both groups were higher than those of this group before treatment,but the research group[(1.65±0.39)]was lower than the control group[(1.97±0.51)],and the difference was statistically significant(P<0.05).Conclusion The combination therapy can significantly improve the condition of patients with refractory schizophrenia and has little negative impact on glucose and lipid metabolism and insulin resistance index,so the combination therapy of clozapine and aripiprazole is considered to be effective and feasible.

关 键 词：难治性精神分裂症 联合用药方案 氯氮平 阿立哌唑 糖脂代谢 胰岛素抵抗 

分 类 号：R749.3[医药卫生—神经病学与精神病学]