| 3种非典型抗精神病药对首发精神分裂症患者血糖血脂、泌乳素、甲状腺激素的影响 |
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| 引用本文： | 莫亚莉,夏泳,陶云海,金曼,赫操.3种非典型抗精神病药对首发精神分裂症患者血糖血脂、泌乳素、甲状腺激素的影响[J].中华全科医学,2017,15(3):479-482. |
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| 作者姓名： | 莫亚莉 夏泳 陶云海 金曼 赫操 |
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| 作者单位： | 杭州市第七人民医院精神科, 浙江 杭州 310013 |
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| 基金项目： | 浙江省医药卫生一般研究项目(2011KYA135) |
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| 摘 要： | 目的 探讨3种非典型抗精神病药对首发精神分裂症患者血糖血脂、泌乳素、甲状腺激素的影响。 方法 85例首发精神分裂症患者分为奥氮平组(29例)、帕利哌酮组(28例)、阿立哌唑组(28例),疗程8周,每组于治疗前后测定空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、泌乳素(PRL)、促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)。 结果 ①治疗后奥氮平组FBG、TG、TC较治疗前显著升高(P<0.05),HDL较治疗前显著降低(P<0.05);帕利哌酮组TG较治疗前显著升高(P<0.05),阿立哌唑组血糖血脂和治疗前比较差异无统计学意义(P>0.05)。②治疗后奥氮平组、帕利哌酮组PRL均较治疗前显著升高(P<0.05),帕利哌酮组升高更明显(P<0.05),阿立哌唑组PRL较治疗前降低,但差异无统计学意义(P>0.05)。③治疗后奥氮平组T3、T4较治疗前显著降低(P<0.05);帕利哌酮组和阿立哌唑组T4、FT4较治疗前显著降低(P<0.05)。④治疗后3组PANSS评分均较治疗前显著降低(P<0.05)。 结论 奥氮平、帕利哌酮和阿立哌唑对首发精神分裂症均有较好的治疗效果;奥氮平明显影响患者血糖血脂,帕利哌酮明显影响甘油三酯,阿立哌唑对血糖血脂影响不明显;三者均引起泌乳素和甲状腺激素的变化,帕利哌酮升高泌乳素更明显。
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| 关 键 词： | 非典型抗精神病药 首发精神分裂症 血糖血脂 泌乳素 甲状腺激素 |
| 收稿时间： | 2016-12-06 |
Effects of three atypical antipsychotics on blood glucose and lipids,prolactin and thyroid hormone in firste-pisode schizophrenic patients |
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| Affiliation: | Department of Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang 310013, China |
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| Abstract: | Objective To investigate the effects of three atypical antipsychotics on blood glucose and lipids,prolactin and thyroid hormone in patients with first-episode schizophrenia. Methods Altogether 85 patients with first-episode schizophrenia were randomly assigned into olanzapine group (n=29),paliperidone group (n=28) and aripiprazole group (n=28) for 8 weeks.The serum levels of fasting blood glucose (FBG),triglyceride (TG),total cholesterol (TC),high density lipoprotein (HDL),low density lipoprotein (LDL),prolactin (PRL),thyroid stimulating hormone (TSH),triiodothyronine (T3),thyroxine (T4),free triiodothyronine (FT3) and free thyroxine (FT4) were measured before and after treatment. Results ①The levels of FBG,TG,and TC in olanzapine group after treatment were significantly higher than those before treatment (P<0.05),HDL was significantly lower than that before treatment (P<0.05);TG in paliperidone group was significantly higher than that before treatment (P<0.05),and no statistical difference was found in blood glucose and lipids compared with those before treatment of aripiprazole group (P>0.05).②The serum PRL of olanzapine group and paliperidone group was significantly higher than those before treatment (P<0.05) with paliperidone group which was found to be increased more significantly (P<0.05),and the PRL of aripiprazole group was decreased but without significant difference (P>0.05).③The levels of T3 and T4 in olanzapine group were significantly lower than those before treatment (P<0.05),and the levels of T4 and FT4 in paliperidone group and aripiprazole group were significantly lower than those before treatment (P<0.05).④PANSS scores of three groups were significantly lower than those before treatment (P<0.05). Conclusion Olanzapine,paliperidone and aripiprazole have significant therapeutic effect on first-episode schizophrenia.Olanzapine affects blood glucose and lipids significantly,paliperidone affects triglycerides significantly,and effects of aripiprazole are not obvious on blood glucose and lipids.All three can affect prolactin and thyroid hormone,and paliperidone is found to significantly increase prolactin. |
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