附加倍他司汀对奥氮平治疗的男性精神分裂症患者体重和脂代谢影响的开放性研究  

An open-ended study:effects of betahistine therapy on body weight and lipid metabolism in olanzapine-treated male schizophrenia

作　　者：白璐源 杨甫德[2] 张小璐 刘小蕾 周晨辉 王永前 王志仁[3] Bai Luyuan;Yang Fude;Zhang Xiaolu;Liu Xiaolei;Zhou Chenhui;Wang Yongqian;Wang Zhiren(Medical Service Division,Beijing Huilongguan Hospital,Huilongguan Clinical Medical School of Peking University,Beijing 100096,China;Office of the Party Committee,Beijing Huilongguan Hospital,Huilongguan Clinical Medical School of Peking University,Beijing 100096,China;Technology Division,Beijing Huilongguan Hospital,Huilongguan Clinical Medical School of Peking University,Beijing 100096,China;Department of Psychology,Mental Health Center of Inner Mongolia Autonomous Region,Hohhot 010110,China;Department of Psychology,Chinese PLA General Hospital,Beijing 100039,China;Department of Pharmacy,the Third Hospital of Chaoyang District,Beijing 100025,China)

机构地区：[1]北京大学回龙观临床医学院北京回龙观医院医务处,100096 [2]北京大学回龙观临床医学院北京回龙观医院党办,100096 [3]北京大学回龙观临床医学院北京回龙观医院科技处,100096 [4]内蒙古自治区精神卫生中心心理科,呼和浩特010110 [5]解放军总医院第一医学中心心理科,北京100039 [6]北京市朝阳区第三医院药剂科,100025

出　　处：《神经疾病与精神卫生》2022年第6期404-408,共5页Journal of Neuroscience and Mental Health

基　　金：北京市科技计划项目(D171100007017002);北京回龙观医院“龙跃”计划项目(2014LYJQ-2)。

摘　　要：目的探索附加倍他司汀对接受奥氮平治疗的男性精神分裂症患者体重和脂代谢的影响。方法选取2020年9月至2021年9月在北京回龙观医院住院的41例男性精神分裂症患者为研究对象。在单药使用奥氮平治疗≥3个月的基础上,附加倍他司汀16 mg,3次/d,进行为期4周的开放性试验。分别于基线期和治疗4周末取晨起空腹静脉血测血常规、空腹血糖、甘油三酯、总胆固醇、肝功能等指标,同一时间测量患者晨起空腹体重、身高、腹围和血压,并计算体重指数(BMI)。采用阳性和阴性症状量表(PANSS)评估患者治疗前和治疗4周末的精神疾病症状的严重程度。采用配对t检验对治疗前后各指标进行统计分析。结果附加倍他司汀治疗4周后,患者体重[(70.1±6.7)kg比(71.7±7.5)kg]、BMI[(24.7±2.1)kg/m^(2)比(25.2±2.4)kg/m^(2)]、总胆固醇水平[(4.3±0.8)mmol/L比(4.6±0.8)mmol/L]低于治疗前,差异有统计学意义(t=4.52、3.97、2.47;P<0.05)。附加倍他司汀治疗前后,患者PANSS总分、血常规指标、谷丙转氨酶比较,差异无统计学意义(P>0.05)。结论附加倍他司汀治疗对男性精神分裂症患者奥氮平相关的体重增加和胆固醇升高具有改善作用。Objective To preliminarily explore the possible effect of betahistine on body weight and lipid metabolism in male schizophrenics treated with olanzapine.Methods A total of 41 male patients with schizophrenics hospitalized in Beijing Huilongguan Hospital from September 2020 to September 2021 were selected.A 4-week open-ended trail were carried out with additional betahistine 16 mg,3 times per day,based on single drug treatment with olanzapine for 4 months and over.Fasting full blood examination,fasting blood sugar,triglyceride,total cholesterol,liver function and other indicators were tested at baseline and the end of 4 weeks'treatment.At the same time,fasting weight,height,abdominal circumference,and blood pressure were measured,and body mass index(BMI)were calculated.Clinical symptoms were assessed at baseline and over 4 weeks using the Positive and Negative Symptom Scale(PANSS).The results of each index before and after the test were statistically analyzed by paired-sample t test.Results After 4 weeks of betahistine intervention,patients'body weight[(70.1±6.7)kg vs(71.7±7.5)kg],BMI[(24.7±2.1)kg/m2 vs(25.2±2.4)kg/m2],and total cholesterol[(4.3±0.8)mmol/L vs(4.6±0.8)mmol/L]were all lower than those before treatment,and the differences were statistically significant(t=4.52,3.97,2.47;P<0.05).There was no significant difference in PANSS total score,blood routine index and alanine aminotransferase before and after treatment with betahistine(P>0.05).Conclusions Betahistine may improve the body weight and cholesterol of male patients with schizophrenia caused by olanzapine.

关 键 词：精神分裂症 倍他司汀 奥氮平 体重 脂代谢 

分 类 号：R749.3[医药卫生—神经病学与精神病学]