【摘要】 目的比较奥氮平、阿立哌唑治疗对精神分裂症患者肝脏脂肪含量(liver fat content,LFC)的影响,探讨LFC与胰岛素抵抗的关系。方法 104例精神分裂症患者采用随机数字表分组,57例接受奥氮平(10~25mg/d)治疗8周(奥氮平组),47例接受阿立哌唑(15~30 mg/d)治疗8周(阿立哌唑组)。治疗前及治疗4周和治疗8周时使用超声定量测定患者LFC,并测定空腹血糖和胰岛素水平以计算胰岛素抵抗指数(homeostasis model assessment of insulin resistance index,HOMA-IR)。结果奥氮平组治疗4周时HOMA-IR、治疗8周时LFC及HOMA-IR均较治疗前增高(P<0.05);阿立哌唑组治疗4和治疗8周时LFC、HOMA-IR较治疗前均无明显差异(P>0.05);奥氮平组治疗8周时LFC、HOMA-IR变化值均高于阿立哌唑组(P<0.05)。奥氮平组治疗8周时LFC变化值与HOMA-IR的变化值呈正相关(r=0.298,P=0.036)。结论奥氮平治疗可升高患者LFC与HOMA-IR,而阿立哌唑对此影响小。更多还原

【Abstract】 Objective To study the liver fat content(LFC) in schizophrenia patients during olanzapine or aripiprazol treatment, and to explore the relation between LFC and insulin resistance(IR).Methods Schizophrenia patients were randomly administered with olanzapine(10~25 mg/d, n=57) or aripiprazole(15~30 mg/d, n=47) for eight weeks. All subjects underwent sonographic quantification of LFC and homeostasis model assessment of insulin resistance index(HOMA-IR) once 0, 4, 8 weeks of treatment.Results Compared with baseline, the levels of HOMA-IR significantly increased after a 4-week and an 8-week of olanzapine treatment, and so did the LFC after an 8-week of olanzapine treatment(P <0.05). The levels of LFC(P >0.05) or HOMA-IR(P >0.05) did not significantly changed at week 4 and 8 in aripiprazol group. The increment of LFC, HOMA-IR at week 8 was significantly higher in olanzapine group than that in aripiprazol group(P<0.05). The change of LFC after 8-weeks olanzapine treatment was positively correlated with the change of HOMA-IR(r=0.298, P=0.036)Conclusion Olanzapine treatment increases whereas aripiprazol has little effect on liver fat and insulin resistance in schizophrenia.更多还原