阿立哌唑联合奥氮平对精神分裂症患者糖脂代谢及内分泌功能影响的研究  

Effects of aripiprazole combined with olanzapine on glucose and lipid metabolism and endocrine function in patients with schizophrenia

作　　者：郑东翠 阚博[1] 朱柏 熊伟[1] ZHENG Dong-cui;KAN Bo;ZHU Bai(Department of General Psychiatry,the Fourth People's Hospital of Wuhu City,Wuhu Anhui 241000,China)

机构地区：[1]芜湖市第四人民医院普通精神科,安徽芜湖241000

出　　处：《临床和实验医学杂志》2024年第7期702-705,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽省医学会临床研究项目(编号:20190001653)。

摘　　要：目的 探究阿立哌唑联合奥氮平对精神分裂症(SCZ)患者糖脂代谢及内分泌功能的影响。方法 将2020年1月至2023年1月芜湖市第四人民医院收治的100例SCZ患者纳入本次回顾性研究,根据治疗方法的不同分为联合组(n=50)和对照组(n=50)。联合组患者接受阿立哌唑联合奥氮平治疗,对照组患者接受奥氮平治疗,两组治疗周期均为8周。比较两组的临床疗效,治疗前、治疗8周后的阳性和阴性症状量表(PANSS)评分、糖脂代谢指标[空腹血糖、胰岛素抵抗指数(HOMA-IR)、甘油三酯、总胆固醇、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)]、内分泌指标[催乳素及三碘甲状腺原氨酸(T3)、甲状腺素、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)]和不良反应发生情况。结果 联合组的总有效率为94.00%,优于对照组(80.00%),差异有统计学意义(P<0.05)。联合组治疗8周后的PANSS总评分为(59.17±8.92)分,显著低于对照组[(70.36±9.77)分],差异有统计学意义(P<0.05)。联合组治疗8周后的空腹血糖、甘油三酯、总胆固醇、LDL-C水平分别为(4.89±0.98)、(1.91±0.75)、(3.71±0.84)、(1.96±0.79) mmol/L,均显著低于对照组[(5.40±1.09)、(2.60±0.89)、(4.30±0.92)、(2.90±0.84) mmol/L],而HOMA-IR、HDL-C水平分别为1.56±0.18、(5.47±0.83) mmol/L,均显著高于对照组[1.34±0.14、(4.92±0.79) mmol/L],差异均有统计学意义(P<0.05)。联合组治疗8周后的催乳素为(16.89±8.01) ng/mL,显著低于对照组[(51.96±9.32)ng/mL],差异有统计学意义(P<0.05),而两组的T3、甲状腺素、FT3和FT4水平比较,差异均无统计学意义(P>0.05)。两组的不良反应发生率比较,差异均无统计学意义(P>0.05)。结论 阿立哌唑联合奥氮平治疗SCZ的疗效显著,可有效改善患者的糖脂代谢,调节内分泌激素水平,且安全性良好。Objective To investigate the effects of aripiprazole combined with olanzapine on glucose and lipid metabolism as well as endocrine function in patients with schizophrenia(SCZ).Methods A retrospective study was conducted on 100 SCZ patients admitted to the Fourth People's Hospital of Wuhu City from January 2020 to January 2023.Based on different treatment methods,the patients were divided into the combination group(n=50) and the control group(n=50).The combination group received aripiprazole combined with olanzapine,while the control group received olanzapine alone.The treatment period was 8 weeks of the two groups.The clinical efficacy,positive and negative symptom scale(PANSS) scores,glucose and lipid metabolism indicators [fasting blood glucose,Homeostasis model assessment for insulin resistance(HOMA-IR),triglycerides,total cholesterol,low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)],endocrine indicators[prolactin and triiodothyronine(T3),thyroxine,free triiodothyronine(FT3),and free thyroxine(FT4)] before and after 8 weeks of treatment,and adverse reactions were compared.Results The total effective rate of the combined group was 94.00%,which was better than that of the control group(80.00%),the difference was statistically significant(P<0.05).The total PANSS score of the combination group after 8 weeks of treatment was(59.17±8.92) points,which was significantly lower than that of the control group(70.36±9.77) points,the difference was statistically significant(P<0.05).After 8 weeks of treatment,the levels of fasting blood glucose,triglycerides,total cholesterol,and LDL-C in the combination group were(4.89±0.98),(1.91±0.75),(3.71±0.84),and(1.96±0.79) mmol/L,respectively,which were significantly lower than those in the control group [(5.40±1.09),(2.60±0.89),(4.30±0.92),and(2.90±0.84) mmol/L],while the levels of HOMA-IR and HDL-C were 1.56±0.18 and(5.47 ± 0.83) mmol/L,respectively,which were higher than those in the control group [1.34±0.14,(4.92±0.79) mmol

关 键 词：精神分裂症 阿立哌唑 奥氮平 糖脂代谢 内分泌功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]