【摘要】 目的探讨奥氮平和利培酮对精神分裂症患者骨钙素和β胶原特殊序列水平的变化及其可能的相关因素。方法收集我院门诊/病房的年龄18~40岁精神分裂症患者90例,其中服用奥氮平的患者45例,服用利培酮的患者45例;收集健康人45例作为对照。收集患者一般人口学资料,采集患者清晨空腹静脉血5 ml,检测催乳素(PRL)、总胆固醇(CHOL)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、血糖(GLU)、胰岛素(INS)、雌二醇(E2)、睾酮、骨钙素(BGP)和β胶原特殊序列(β-CROSSL)。结果 (1)与正常对照组相比,奥氮平组和利培酮组患者BGP和β-CROSSL水平明显升高,且差异具有统计学意义(P<0.05);但奥氮平组和利培酮组间BGP和β-CROSSL水平差异无统计学意义(P>0.05)。(2)服药组的用药时间、LDL和GLU与BGP成负相关,INS和睾酮与BGP成正相关;药物和服药时间与β-CROSSL成正相关,LDL、GLU和E2与β-CROSSL成负相关。结论长期服药精神分裂症患者出现的糖脂代谢异常可能是导致骨质疏松出现的危险因素之一。更多还原

【Abstract】 Objective To evaluate the changes in osteocalcin( BGP) and β-Cross Laps( β-CROSSL) in schizophrenia patients treated with olanzapine or risperidone and to study potential factors that influences bone metabolism. Methods A total of 90 schizophrenic patients aged 18-40 years were included in the study. Among them 45 patients were treated with olanzapine and 45 patients were treated with risperidone for at least 6 months. Forty-five healthy volunteers acted as normal controls. Serum prolactin( PRL),triglyceride( TG),cholesterol( CHOL),high density lipoprotein( HDL),lowdensity lipoprotein( LDL),sex hormone,glucose( GLU),insulin( INS),BGP,β-CROSSL were measured in all subjects. Results( 1) Compared with the normal controls,both BGP and β-CROSSL were increased in patients treated with olanzapine and risperidone( P < 0. 05),whereas there was no significant differences in the levels of BGP and β-CROSSL between the olanzapine and risperidone group( P > 0. 05).( 2)Medication time,LDL and GLU were negatively associated with serum BGP levels,and INS and testosterone were positively associated with serum BGP levels; antipsychotics and medication time were positively associated with serum β-CROSSL levels,and LDL,GLU and E2 were negatively associated with serum β-CROSSL levels. Conclusion Our study showed that bone turnover rate significantly increased in patients treated with olanzapine and risperidone,and abnormalities of glucose and lipid metabolism in patients treated with atypical antipsychotics may be one of the risk factors of osteoporosis.更多还原