碳酸锂联合奥氮平治疗儿童青少年双相情感障碍疗效及对代谢指标的影响  

Comparison of the therapeutic effects and metabolic indicators of lithium carbonate combined with olan-zapine in the treatment of bipolar disorder in children and adolescents

作　　者：姜源 虞海萍 邱丽雪 戴凌一 Jiang Yuan;Yu Haiping;Qiu Lixue;Dai Lingyi(Department of Psychiatry,Wenzhou Seventh People′s Hospital,Wenzhou,Zhejiang,325000,China)

机构地区：[1]温州市第七人民医院精神科,浙江温州325000

出　　处：《中国药物与临床》2025年第5期295-299,共5页Chinese Remedies & Clinics

摘　　要：目的探讨碳酸锂联合奥氮平治疗儿童青少年双相情感障碍疗效及对代谢指标观察。方法以浙江省温州市第七人民医院精神科2022年9月至2022年12月收治的儿童青少年双相情感障碍患者作为研究对象,110例患者按治疗方法分为2组:观察组(55例)采用情感稳定剂碳酸锂联合奥氮平治疗,对照组(55例)采用奥氮平治疗。比较2组患者疗效、糖脂代谢指标[胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)]、肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)]、倍克-拉范森躁狂量表(BRMS)评分、汉密尔顿抑郁量表(HAMD)评分及不良反应发生率。结果与对照组比较,观察组临床疗效更高(94.6%与80.0%)(P<0.05);与治疗前比较,2组治疗后BRMS评分及HAMD评分均降低(P<0.05);与对照组治疗后比较,观察组治疗后BRMS评分及HAMD评分均降低更明显(P<0.05);与治疗前比较,对照组治疗后FPG、2hPG、HbA1c、TC、TG、LDL-C水平升高,HDL-C水平降低(P<0.05);观察组治疗前后血脂代谢指标差异无统计学意义(P>0.05);与对照组治疗后比较,观察组治疗后FPG、2hPG、TC、TG、LDL-C水平均明显降低,HDL-C水平明显升高(P<0.05);与治疗前比较,2组治疗后血清ALT、AST水平均上升(P<0.05);与对照组治疗后比较,观察组治疗后血清ALT、AST水平均更低(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论碳酸锂联合奥氮平治疗儿童青少年双相情感障碍可有效改善其躁狂、抑郁症状,对糖脂代谢、肝功能影响小,且疗效显著,未增加不良反应发生,值得临床推荐应用。Objective To compare the efficacy and to observe the metabolic indexes of lithium carbonate combined with olanzapine in the treatment of bipolar disorder in children and adolescents.Methods A total of 110 children and adolescents with bipolar disorder admitted to Wenzhou Seventh People′s Hospital from Septem-ber 2022 to December 2022 were divided into a control group and an observation group(55 cases in each group)according to treatment.The observation groupreceived emotional stabilizer lithium carbonate combined with olan-zapine,and the control group received olanzapine alone.The study compared the therapeutic efficacy,glucose and lipid metabolism indicators[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),glycated hemoglobin(HbA1c)],liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST)],Beck Raphson Mania Scale(BRMS)scores,Hamilton Depression Rating Scale(HAMD)scores,and the incidence of adverse reactions between two groups of patients.Results Compared with the control group,the clinical efficacy of the observation group was significantly better(94.6%vs 80.0%)(P<0.05).Both groups showed a significant reduction in BRMS scores and BRMS scores after treatment(P<0.05).The reduction in BRMS scores and BRMS scores of the observation group were more significant than the control group(P<0.05).In the control group,the levels of FBG,2 hPG,HbA1c,TC,TG and LDL-C increased significantly after treatment,while the levels of HDL-C decreased signifi-cantly(P<0.05).There was no significant change in blood lipid metabolism index in the observation group before and after treatment(P>0.05).Compared with the control group,the levels of FBG,2 hPG,TC,TG and LDL-C in the observation group were significantly decreased,while the levels of HDL-C significantly increased(P<0.05).The levels of ALT and AST in both groups increased significantly after treatment(P<0.05).The levels of ALT and AST in the obs

关 键 词：碳酸锂 非典型抗精神病药 儿童青少年 双相情感障碍 治疗结果 糖脂代谢 肝功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]