第二代抗精神病药物对精神分裂症患者代谢综合征相关指标影响的网状Meta分析  

Effects of second-generation antipsychotic drugs on metabolic syndrome-related indicators in patients with schizophrenia:a network meta-analysis

作　　者：徐赫 张梦然 曹阳[1] 管欣[1] 王璐颖 钱焊森 刘晶 马爱霞[1] 李洪超[1] XU He;ZHANG Meng-ran;CAO Yang;GUAN Xin;WANG Lu-ying;QIAN Han-sen;LIU Jing;MA Ai-xia;LI Hong-chao(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing 211198,China;Sumitomo Dainippon Pharma Co.,Ltd.,Suzhou 215000,China)

机构地区：[1]中国药科大学国际医药商学院,南京211198 [2]住友制药(苏州)有限公司,苏州215000

出　　处：《中国新药杂志》2022年第19期1952-1961,共10页Chinese Journal of New Drugs

摘　　要：目的:系统评价7种第二代非典型抗精神病药物对代谢综合征相关指标的影响。方法:计算机检索PubMed、The Cochrane Library、EMbase、万方数据库、CNKI中国知网和维普数据库,搜集报告相关指标的随机对照试验(RCT),检索时限均从2004年1月—2019年12月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R 3.6.1软件和Gemtc软件进行网状Meta分析。结果:共纳入87个RCT,网状Meta结果显示:体重方面,布南色林、氨磺必利和阿立哌唑较少引起体重增加,奥氮平和喹硫平更易引起体重和身体质量指数(BMI)增加;空腹三酰甘油(TG)指标方面,帕利哌酮对TG影响较小,奥氮平影响较大;空腹高密度脂蛋白胆固醇(HDL-C)指标方面,阿立哌唑引起HDL-C降低较少,奥氮平降低较多;空腹血糖(FPG)指标方面,氨磺必利较少引起FPG升高,奥氮平则表现较差。结论:奥氮平和喹硫平相对于其他药物更易引起代谢综合征相关指标的异常,但在临床实际用药中仍需结合药物疗效进行综合考量,对患者进行个性化治疗。Objective:To systematically evaluate the effects of seven second-generation atypical antipsychotics on metabolic syndrome-related indicators.Methods:Databases including PubMed,the Cochrane Library,EMbase,WanFang Data,CNKI,and VIP were electronically searched to collect randomized controlled trials(RCTs)containing relevant indicators from January 2004 to December 2019.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included studies.R 3.6.1 software and Gemtc software were used for meta-analysis.Results:A total of 87 RCTs were included.In terms of weight,meta results show that blonanserin,amisulpride,and aripiprazole caused less weight gain,and olanzapine and quetiapine were more likely to cause weight and body mass index(BMI)increase.For fasting triglyceride(TG)indicators,paliperidone had a small effect on TG,olanzapine had a greater effect.For fasting high-density lipoprotein cholesterol(HDL-C)indicators,aripiprazole caused HDL-C decreased less,olanzapine decreased more.While for fasting blood glucose index(FPG),amisulpride caused less increase in FPG,and olanzapine performed poorly.Conclusion:Compared with other drugs,olanzapine and quetiapine are more likely to cause abnormalities in the indicators related to metabolic syndrome.However,it is still necessary to comprehensively consider the efficacy of the drug in order to achieve personalized treatment of patients in clinical practice.

关 键 词：精神分裂症 代谢综合征 网状Meta 

分 类 号：R971.4[医药卫生—药品]