利培酮对首发精神分裂症患者糖耐量、脂代谢及体质量影响  

Effects of risperidone on glucose and lipid metabolism as well as body weight in patients with first-episode schizophrenia

作　　者：白璐源 陈大春[1] 陈科[1] 范宁[1] 梁伟业[1] BAI Lu-yuan;CHEN Da-chun;CHEN Ke;FAN Ning;LIANG Wei-ye(Beijing Hui Long Guan Hospital,Beijing 100096,China)

机构地区：[1]北京回龙观医院,100096

出　　处：《临床精神医学杂志》2023年第3期213-215,共3页Journal of Clinical Psychiatry

基　　金：首都卫生发展科研专项基金资助(2018-2-2131)。

摘　　要：目的:探讨利培酮治疗对首发精神分裂症患者糖耐量、脂代谢及体质量的影响。方法:将125例首发精神分裂症患者使用利培酮治疗10周。分别于治疗前及治疗后对患者进行口服葡萄糖耐量试验(OGTT),并测总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、血浆葡萄糖、血清胰岛素水平,胰岛素抵抗稳态模型(HOMA-IR)用于胰岛素抵抗评估。结果:利培酮治疗后患者体质量、BMI、腰围、腰臀比均较治疗前增加(P<0.001)。胰岛素和HOMA-IR水平与治疗前相比明显升高(P<0.001)。治疗后总胆固醇和三酰甘油水平较治疗前增加(P均<0.05)。利培酮治疗后,男性患者的体质量增加、腰围和腰臀比高于女性患者(P<0.01)。结论:利培酮治疗可升高首发精神分裂症患者的胰岛素、血脂、HOMA-IR水平;体质量增加、BMI、腰围和腰臀比也升高,且男性患者较女性患者增加更为明显。Objective:To investigate the effects of risperidone treatment on glucose tolerance,lipid metabolism and body mass in patients with first-episode schizophrenia.Method:125 patients with first-episode schizophrenia were included and treated with risperidone for 10 weeks.Oral glucose tolerance test(OGTT)was performed before and after treatment,and total cholesterol,triacylglycerol,high density lipo protein(HDL),low density lipo protei(LDL),plasma glucose,serum insulin levels were measured,insulin resistance were asessed by Homeostasis model of insulin resistance(HOMA-IR).Results:Patients'body mass,BMI,waist circumference and waist-to-hip ratio increased after 10 weeks of risperidone treatment compared to pre-treatment(P<0.001).Insulin and HOMA-IR levels were significantly higher compared to pre-treatment(P<0.001).Total cholesterol and triacylglycerol levels increased after treatment compared to pre-treatment(both P<0.05).After 10 weeks of risperidone treatment,male patients had a higher increase in body mass,waist circumference and waist-to-hip ratio than female patients(P<0.01).Conclusion:Insulin,lipid and HOMA-IR levels increase in patients with first-episode schizophrenia after risperidone treatment.Body mass,BMI,waist circumference and waist-to-hip ratio increase after treatment,and the increases are more obvious in male patients than in female patients.

关 键 词：首发 精神分裂症 利培酮 口服葡萄糖耐量试验 

分 类 号：R749.3[医药卫生—神经病学与精神病学]