不同剂量二甲双胍联用利培酮所致精神分裂症患者代谢综合征的临床观察  

Clinical observation of different doses of metformin in the prevention and treatment of risperidone⁃induced metabolic syndrome in patients with schizophrenia

作　　者：吴娇 杨广 王馨 Wu Jiao;Yang Guang;Wang Xin(Department of Pharmacy,The Third People’s Hospital of Tongling City,Tongling 244000,China)

机构地区：[1]铜陵市第三人民医院药剂科,安徽铜陵244000

出　　处：《海军医学杂志》2025年第3期297-301,共5页Journal of Navy Medicine

摘　　要：目的 探究不同剂量二甲双胍联用利培酮所致精神分裂症患者代谢综合征的临床观察。方法 选取安徽省铜陵市第三人民医院2017年1月至2021年12月收治的77例精神分裂症患者作为研究对象,所有患者均采用二甲双胍联合利培酮治疗,根据不同的二甲双胍剂量分为2组,其中A组32例,B组45例。A组给予二甲双胍0.5 g/d(0.25 g/次,2次/d),B组给予二甲双胍0.75 g/d(0.25 g/次,3次/d)。连续服用8周后,根据阳性症状评定量表(SAPS)及阴性症状评定量表(SANS)总分评估患者临床疗效,比较不同剂量对患者体重、糖脂代谢指标的控制情况,并观察治疗方案的安全性。结果 B组总有效率为95.56%(43/45),高于A组的78.13%(25/32),差异有统计学意义(P<0.05);治疗后A组空腹血糖(FBG)水平降低,体重指数(BMI)和腰围均增加;治疗后B组FBG水平降低,腰围增加,且A组均高于B组(P<0.05);治疗后A组甘油三酯(TG)、总胆固醇(TC)水平升高,治疗后B组TG水平升高,且A组TG、TC水平均高于B组(P<0.05);A、B组的不良反应率分别为15.63%(5/32)和22.22%(10/45),差异无统计学意义(P>0.05)。结论 与低剂量(0.5 g/d)二甲双胍比较,高剂量(0.75 g/d)二甲双胍联合利培酮对FES患者的体重控制及糖脂代谢水平的控制效果更佳,对于FES患者具有一定安全性,同时疗效更佳。Objective To investigate the clinical effect of different doses of metformin on risperidone-induced metabolic syndrome in patients with schizophrenia.Methods A total of 77 patients with schizophrenia who were admitted to the Third People’s Hospital of Tongling City from January 2017 to December 2021 were enrolled.All the patients were treated with metformin and risperidone.According to the dose of metformin,they were assigned to group A(n=32)and group B(n=45).Group A was given metformin 0.5 g/d(0.25 g each time,twice a day),and group B was given metformin 0.75 g/d(0.25 g each time,3 times a day).After 8 weeks of continuous administration,the clinical efficacy was evaluated according to the total score of the scale for assessment of positive symptoms(SAPS)and the scale for assessment of negative symptoms(SANS).The body weight and glucolipid metabolism indexes were compared between patients with different doses of metformin.The safety of treatment was recorded.Results The total effective rate of group B was 95.56%(43/45),which was higher than that of group A(78.13%[25/32],P<0.05).After treatment,the fasting blood glucose(FBG)level decreased and body mass index(BMI)and waist circumference increased in group A,FBG level decreased and waist circumference increased in group B.The FBG,BMI and waist circumference in group A were higher than those in group B after treatment(P<0.05).Triacylglycerol(TG)and total cholesterol(TC)in group A and TG in group B increased after treatment,and the levels of TG and TC in group A were higher than those in group B(P<0.05).The adverse reaction rates of group A and B were 15.63%(5/32)and 22.22%(10/45),respectively(P>0.05).Conclusion Compared with low dose(0.5 g/d)of metformin,high dose(0.75 g/d)of metformin combined with risperidone has better effects on weight control and glucolipid metabolism in patients with schizophrenia,with certain safety and better efficacy.

关 键 词：二甲双胍 利培酮 精神分裂症 疗效 

分 类 号：R749.3[医药卫生—神经病学与精神病学]