【摘要】 目的了解利培酮、氯氮平、氯丙嗪长期治疗后糖脂代谢的情况及其之间的差别。方法检测42例利培酮、76例氯氮平、40例氯丙嗪单一治疗连续2年以上的精神分裂症患者的简易体质参数、空腹血糖和血脂,并与63例健康对照者的资料进行比较。结果利培酮、氯氮平、氯丙嗪治疗期间新出现的糖尿病病例数分别为2例、8例、2例,氯氮平组较多,但3组间无统计学差异(P>0.05)。氯氮平组BM I大于对照组、氯丙嗪组,腰围及腰臀比利培酮组、氯氮平组均大于对照组和氯丙嗪组(P<0.05或P<0.01);氯氮平组TG值大于对照组及氯丙嗪组(P<0.01),利培酮组、氯氮平组、氯丙嗪组HDL-ch、ApoA1值均小于对照组(P<0.05或P<0.01),两两比较利培酮组HDL-ch、ApoA1值大于氯氮平组及氯丙嗪组(P<0.01)。TG/HDL-ch值氯氮平组大于对照组(P<0.01)和氯丙嗪组(P<0.05)。TC/HDL-ch值三组均大于对照组(P<0.01),但三组间无明显差异。ApoB值三组与对照组相比无明显差异(P>0.05)。结论利培酮、氯氮平、氯丙嗪长期治疗的精神分裂症患者存在一定糖脂代谢紊乱,并且三者对糖脂代谢的影响存在一定差异,氯氮平治疗组脂代谢异常更明显,值得临床重视。更多还原

【Abstract】 Objective: To investigate the potential effects of long term medication on glucose metabolism and lipid metabolism among the patients with schizophrenia who had been treated with risperidone,clozapine,or chlorpromazine.Methods: The height,body weight,waist circumference,hip circumference,and the fasting blood glucose and lipid profile were measured in schizophrenia patients treated with risperidone(42 cases),clozapine(76 cases),or chlorpromazine(40 cases) respectively for at least 2 years,and the data were compared with 63 normal controlls.Results:There were 2,8,2 new cases of diabetes during the treatment of risperidone,clozapine and chlorpromazine respectively,and no differences of the incidence were found among the three groups(P>0.05).The body mass index(BMI) in clozapine group was larger than those of chlorpromazine group and control group;waist circumference and waist/hip circumference ratio in risperidone group and clozapine group were larger than those of chlorpromazine group and control group(P<0.05或P<0.01).The triglyceride(TG) level in clozapine group was significantly higher than those of chlorpromazine group and control group(P<0.01).The levels of apolipoprotein AI(ApoAI)and high-density lipoprotein cholesterol(HDL-ch) were lower in all these three treatment groups than that of control group.The level of TG/HDL-c in clozapine group was higher than those of chlorpromazine group and control group.The level of cholesterol /HDL-ch(TC/HDL-c) in the tratment groups was lower than that of control group,but there were no differences among the three groups.There were no differences in apolipoprotein B(ApoB) among four groups.Conclusion:There were some disturbance in glucose metabolism and lipid metabolism in the schizophrenia patients with long term treatment of these 3 antipsychotics,which had different impacts on the metabolism and clozapine had most severe effects on lipid metabolism.Physicians should pay more attention to it.更多还原