【摘要】 目的研究奥氮平治疗精神分裂症患者早期的食欲改变对后期体重增加的影响。方法以首次发病、未治疗的精神分裂症患者为对象,测量治疗前及奥氮平治疗后第1、2、3、4、8、12、16周末的体重,并分别进行饮食行为量表评定,评估奥氮平治疗后早期(第1、2、3周末)的食欲改变和体重变化(早期体重增加定义为≥基线体重3%)对后期(第16周末)获得有临床意义的体重增加(clinically significant weight gain,CSWG)/肥胖的预测效能(远期体重增加定义为≥基线体重7%)。结果奥氮平治疗后早期(第1、2、3周末)的食欲改变和体重变化,对后期(第16周末)体重增加的阳性预测值为100%,阴性预测值分别为42.86%、60%、78.95%,ROC曲线下面积分析分别为0.714、0.80、0.90。并用Pearson相关分析方法进一步研究早期食欲改变与远期体重增加的关系,食欲改变(第1、2、3周末)与第16周末的Pearson相关分析,P<0.05,r值分别为0.29、0.48、0.61。早期食欲改变明显,体重增加明显,后期体重增加更明显,呈正相关。尤其是治疗第3周末食欲改变明显,第16周末体重增加明显。女性较男性体重增加明显,且基础体重越小,年龄越小,体重增加越明显。结论早期食欲改变可能与奥氮平后期体重增加有关。更多还原

【Abstract】 Objective To study the influence of early appetite changes on weight gain of schizophrenia patients those who received the treatment of olanzapine. Methods First onset and untreated patients with schizophrenia were selected as study subjects. Body mass of the patients were measurement before treatment and at the 1^st,2^nd,3^rd,4^th,8^th,12^th,and 16 thweekends after the treatment of olanzapine,and the patients were assessed by eating behavior scale. To analysis the predictive efficacy of early( the 1^st,2^nd,and 3^rd weekends after treated by olanzapine) appetite and weight change（ early weight gain is defined as over 3% the baseline weight）on obtaining clinical significant weight gain（ CSWG）/obesity（ long-term weight gain defined as 7% over baseline weight） during the late period of treatment（ 16 thweekend）.Results The positive predictive values of early( the1^st,2^nd,and 3^rd weekends after treated by olanzapine) appetite and weight change on weight gain at the later stage（ 16 thweekend） was 100%,and the negative predictive values were 42. 86%,60% and 78. 95%,respectively. The area under the ROC curve was 0.714,0.80 and 0.90,respectively. Pearson correlation analysis was used to further study the relationship between early appetite change and long-term weight gain. Pearson correlation analysis of appetite change( 1^st,2^nd and 3^rd weekend) and 16 th weekend showed that P< 0.05 and r value were 0.29,0.48 and 0.61,respectively. The significant changes in appetite in early stage and significant weight gain,the more significant weight gain in later stage. Especially,the change of appetite was obvious at the third weekend of treatment,and the weight gain was obvious at the 16 th weekend. The weight gain of female is more obvious than that of male,and the smaller the base weight is,the younger the age is,the more obvious the weight gain is. Conclusions Early change of appetite may be related to weight gain in later stage of olanzapine treatment.更多还原