氯氮平和利培酮对糖脂代谢的影响(1)
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2010年7月1日
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【摘要】目的 研究氯氮平和利培酮对糖脂代谢的影响。方法 60例精神分裂症患者根据临床治疗需要分为氯氮平组(30例)和利培酮组(30例),治疗观察4周。每组患者于治疗前后测空腹血糖、甘油三脂、胆固醇、空腹胰岛素、空腹C肽,量身高、体重、腰围、臀围,并计算体重指数(BMI)及胰岛素抵抗指数(IR)。结果 (1)治疗后两组患者的胰岛素、C肽、IR均升高,与治疗前的差异有统计学意义(P<0.05);治疗后氯氮平组患者的甘油三脂、胆固醇均明显高于治疗前(P<0.05);(2)治疗后BMI、胰岛素、C肽、甘油三脂、胆固醇、IR的升高程度氯氮平大于利培酮(差异均有显著性P<0.05)。结论 氯氮平对糖代谢及脂代谢的影响大于利培酮。
【关键词】氯氮平 利培酮 糖代谢 脂代谢
中图分类号:R971.41 文献标识码:A 文章编号:1005-0515(2010)07-034-03
The side-effects of clozapine and risperidone on the glucose metabolism and lipid metabolism
Li yu ming
(Third people’s Hospital of Zhongshan guangdong; Zhongshan 528400)
【Abstract】Objective To study the side-effects of clozapine and risperidone on the glucose metabolism and lipid metabolism in schizophrenic patients.Methods Sixty schizophrenic patients were divided into clozapine group and risperidone group. Before and after four-week treatment, some data which include height, body weight, chest(abdomem) circumference, buttock circumference, the fasting blood glucose, the fasting insuline, C-peptide, cholesterol and triglyceride were measured. In addition, the body mass index (BMI) and insulin resistance (IR) were calculated. Results After treatment, the fasting serum insulin ,C-peptide and IR levels increased significantly in two groups,Has statistics significance before the treatment difference (P<0.05); Cholesterol and triglyceride concentration significantly increased in clozapine group(p<0.05); The increased level of BMI, the fasting insuline, C-peptide, cholesterol, triglyceride and IR was clozapine above risperidone(The difference has significance P<0.05). Conclusions The effects of clozapine on the glucose metabolism and lipid metabolism outweight those of risperidone.
【Key words】Clozapine Risperdone Glucose metabolism Lipid metabolism
近年来,国内外出现大量有关抗精神病药引起糖代谢及脂代谢异常的报道。有约50%的患者在长期服用经典或非经典抗精神病药后出现明显的体重增加。我们探讨比较氯氮平和利培酮对精神分裂症患者糖代谢及脂代谢的影响,旨在为临床合理用药提供参考依据。
1 对象和方法
1.1对象
1.1.1 入组标准和排除标准:(1)符合中国精神障碍分类与诊断标准第3版的精神分裂症的诊断标准,入院前至少1个月内未服用任何精神药物;(2)空腹血糖值<6.7 mmol/L,肝、肾功能及血常规检测正常;(3)排除有糖尿病、高血压及肝、肾功能不全等重大躯体疾病史者;(4)排除药物及酒精依赖者。
1.1.2 一般资料:共入组64例,均为2008年5月至2009年10月在我院住院的患者 ......
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