超声定量评价抗精神药物对肝脏脂肪含量的影响  

Effect of antipsychotics drugs on liver fat content by ultrasound quantification

作　　者：孙林琳 李楠 张立刚[1] 陈景旭[1] SUN Lin-lin;LI Nan;ZHANG Li-gang;CHEN Jing-xu(Beijing HuiLongGuan Hospital,Beijing 100096,China)

机构地区：[1]北京回龙观医院,北京100096

出　　处：《中国新药杂志》2022年第3期251-256,共6页Chinese Journal of New Drugs

基　　金：首都临床特色应用研究与成果推广项目(Z171100001017001)。

摘　　要：目的:利用超声定量技术计算抗精神药物对肝脏脂肪含量(FLC)的影响。方法:168例接受抗精神病药物治疗的患者作为研究组,另外采用非概率抽样方法选取未接受过任何治疗的38例健康志愿者作为对照组。采集研究对象的一般资料、体重指数(BMI)、实验室检查和超声诊断脂肪肝的结果。利用超声定量技术计算研究对象的FLC,评价FLC与抗精神病治疗药物、治疗时间的相关性。结果:治疗组患者的BMI、血清谷丙转氨酶(ALT)、总胆固醇(TC)和三酰甘油(TG)值均高于对照组。接受抗精神病药物治疗的患者FLC明显高于对照组。奥氮平治疗组患者多脂肪含量(22.15±16.47)%、衰减系数(0.0193±0.0139)及肝肾比值(0.79±0.27)均高于其他药物治疗组(P=0.040)。FLC与抗精神病药物治疗时间及BMI,ALT,TG呈正相关,治疗时间超过3年的患者FLC为(40.83±19.34)%,明显高于治疗时间为1年的患者[(14.27±12.20)%,P<0.001]。结论:奥氮平对FLC的影响较大,长期服用抗精神病药物可引起患者体内脂肪含量的增加。超声定量分析可以客观评价FLC,帮助临床实时、便捷地检测药物治疗对FLC的影响。Objective:To evaluate the effect of antipsychotics drugs(APDs)on liver fat content(FLC)by ultrasonic quantitative technique.Methods:A total of 168 patients receiving APDs were enrolled in the study group,and 38 healthy volunteers who had not received any treatment were randomly selected as the control group.General data,BMI,laboratory examination and ultrasonic diagnosis of fatty liver were collected.FLC of these people was calculated by ultrasonic quantitative technique,and the correlations of FLC,APDs and the treatment duration were evaluated.Results:BMI,serum levels of ALT,TC and TG in the treatment group were all higher than those in the control group.The FLC of the patients receiving APDs was significantly higher than that of the control group.The fat content(22.15±16.47)%,attenuation coefficient(0.0193±0.0139)and liver/kidney ratio(0.79±0.27)in the olanzapine treatment group were higher than those in other drug treatment groups(P=0.040).FLC was positively correlated with the duration of APDs,BMI,ALT and TG.The FLC of patients with treatment duration of more than 3 years was(40.83±19.34)%,significantly higher than that of patients with treatment duration of 1 year(14.27±12.20%,P<0.001).Conclusion:Treatment of olanzapine has a great influence on LFC in patients;meanwhile,long-term of APD treatment can increase the precentage of LFC.LFC can be objectively evaluated by ultrasonic quantitative analysis,and help to conveniently monitor the real-time change of liver function caused by APDs in clinic.

关 键 词：抗精神疾病药物 脂肪肝 超声定量分析 肝脏脂肪含量 

分 类 号：R969.4[医药卫生—药理学] R971[医药卫生—药学]