【摘要】 目的探讨精神分裂症患者氯丙嗪和利培酮治疗中血糖调节功能受损的影响因素。方法将198例住院精神分裂症患者分为氯丙嗪组103例和利培酮组95例,用药前和用药1,2,3,6和12个月后分别测定空腹血糖、2 h糖耐量、糖化血红蛋白、C反应蛋白、甘油三酯、高密度脂蛋白、低密度脂蛋白、载脂蛋白A、B及体质量指数等相关指标。结果随着治疗时间延长,血糖调节功能受损(IGR)的发生率逐渐增加。治疗1年后IGR的发生率与发病年龄、治疗前2 h糖耐量、治疗1年后载脂蛋白A和B、糖化血红蛋白、氯丙嗪治疗等五项因素有关,与药物日剂量无关。结论抗精神病药物使用早期能引起IGR,年龄大、血脂代谢紊乱以及用药前糖耐量相对较高者是危险因素。更多还原

【Abstract】 Objective To explore the influencing factors of blood glucose regulation disfunction in schizophrenic patients treated with chlorpromazine and risperidone.Methods A total of 198 patients with schizophrenia were randomized into chlorpromazine group(103 cases) and risperidone group(95 cases).At baseline and at the end of the 1st,2nd,3rd,6th,12th month of the treatment,all patients were measured with fasting blood glucose,2 hours glucose tolerance,glycated hemoglobin,C-reactive protein,triglyceride,high density lipoprotein,low density lipoprotein,apolipoprotein A,apolipoprotein B,body mass index and other related indices.Results Impaired glucose regulation(IGR) increased gradually with the treatment prolonged.Incidence of 1-year IGR was related with age of onset,2 hours glucose tolerance at baseline,apolipoprotein A and B at the end of 1 year,glycated hemoglobin,chlorpromazine treatment.IGR had nothing to do with the daily dose of drug.Conclusion Antipsychotics can cause IGR in early stage of the treatment.Older age,dyslipidemia and impaired glucose tolerance before treatment are risk factors of IGR.更多还原