利培酮对未成年精神障碍患者糖脂代谢影响的Meta分析  

Meta-Analysis of the Effect of Risperidone on Glycolipid Metabolism in Minors with Mental Disorder

作　　者：杨潞 安奕舟 刘雪梅[1] 胡昌华[1] 曾令高 YANG Lu;AN Yizhou;LIU Xuemei;HU Changhua;ZENG Linggao(School of Pharmacy,Southwest University,Chongqing,China 400715;Chongqing Institute of Food and Drug Inspection and Testing·NMPA Key Laboratory for Quality Monitoring of Narcotic Drugs and Psychotropic Substances,Chongqing,China 401121)

机构地区：[1]西南大学药学院,重庆400715 [2]重庆市食品药品检验检测研究院·国家药品监督管理局麻醉精神药品质量监测重点实验室,重庆401121

出　　处：《中国药业》2023年第16期114-119,共6页China Pharmaceuticals

基　　金：重庆市自然科学基金[cstc2020jcyj-msxmX0424];重庆市科研机构绩效激励引导专项[cstc2021jxjl130024]。

摘　　要：目的为未成年精神障碍患者临床合理使用利培酮提供循证参考。方法检索PubMed、Web of Science、Science Direct、中国知网、维普和美国临床试验数据库,检索时限为各数据库自建库起至2022年12月,纳入利培酮治疗未成年精神障碍疾病的随机对照试验(RCT)文献及研究,收集并整理数据。采用Cochrane偏倚风险评估工具(第二版)评估文献质量;采用RevMan 5.4统计学软件进行Meta分析,采用倒漏斗图分析潜在的发表偏倚。结果共纳入21篇文献和1项研究;其中3篇为高风险,7篇和1项研究有一定风险,11篇为低风险;共涉及1745例患者。试验组患者体质量增加、总胆固醇升高、食欲增加的发生率均明显高于对照组(P<0.05)。试验组门诊、住院患者体质量增加发生率及门诊患者三酰甘油升高发生率均明显高于对照组相应亚组(P<0.05),但试验组两亚组患者食欲增加发生率与对照组相应亚组无明显差异(P>0.05)。结论未成年精神障碍患者经利培酮治疗后体质量和食欲增加发生率会明显升高,血糖、血脂指标也会出现异常,通过合理控制饮食,在能量消耗方面进行干预,可改善利培酮所致糖脂代谢紊乱问题。Objective To provide an evidence-based reference for the rational clinical use of risperidone in minors with mental disorder.Methods The papers and researches of randomized controlled trials(RCTs)of risperidone in the treatment of minors with mental disorder in the PubMed,Web of Science,ScienceDirect,CNKI,VIP and ClinicalTrials from the inception of each database to December 2022 were searched,the data were collected and sorted out.The Cochrane risk of bias assessment tool(Version 2)was used to evaluate the quality of papers,the RevMan 5.4 statistical software was used for Meta-analysis,and the inverted funnel plot was used to analyze the potential publication bias.Results A total of 21 papers and one research were included,including three papers with high risk,seven papers and one research with a certain risk,and eleven papers with low risk,involving 1745 patients.The incidence of increased body mass,total cholesterol(TC)and appetite in the test group was significantly higher than that in the control group(P<0.05).The incidence of increased body mass of outpatients and inpatients and increased triglyceride(TG)of inpatients in the test group was significantly higher than that of corresponding subgroups in the control group(P<0.05),but the incidence of increased appetite of outpatients and inpatients in the test group was similar to that in the control group(P>0.05).Conclusion After treatment with risperidone,the incidence of increased body mass and appetite in minors with mental disorder will significantly increase,and their blood glucose and blood lipid indicators are abnormal.The glycolipid metabolism disorder induced by risperidone can be improved by reasonable control of diet and intervention in energy expenditure.

关 键 词：利培酮 未成年患者 精神障碍 体质量 糖脂代谢 食欲 

分 类 号：R969.3[医药卫生—药理学] R971.41[医药卫生—药学]