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1.
目的:探讨非经典抗精神病药对精神分裂症患者血糖、糖化血红蛋白(HbA1C)、三酰甘油(TG)、高密度脂蛋白(HDL)和体质量的影响。方法:将176例精神分裂症患者分成氯氮平组(30例)、奥氮平组(30例)、奎硫平组(30例)、利培酮组(30例)、阿立哌唑组(30例)和齐拉西酮组(26例),治疗6周。于治疗前和治疗6周测量空腹血糖、HbA1C、TG、HDL和体质量。结果:治疗前后血糖、HbA1C、TG、HDL和体质量在阿立哌唑组和齐拉西酮组无显著变化,氯氮平组和奥氮平组治疗后显著增高(P〈0.05或P〈0.01);奎硫平组和利培酮组可引起体质量显著增加(P〈0.01),但对血糖、HbA1C、TG、HDL影响不大。结论:阿立哌唑、齐拉西酮对精神分裂症患者代谢的影响较小,奎硫平、利培酮次之,氯氮平、奥氮平对患者代谢的影响最大。  相似文献   

2.
目的探讨氯氮平、利培酮、齐拉西酮三种抗精神病药物对精神分裂症患者脂代谢的影响。方法将符合CC-MD-3精神分裂症诊断标准的187例精神分裂症患者随机分成氯氮平、利培酮、齐拉西酮3组,分别给予单药治疗6个月。于治疗前及治疗第1、2、3、6个月末监测血脂、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL))等项指标,同时评定症状程度。结果治疗后较治疗前氯氮平组、利培酮组在血脂各指标数值均增加,且在体质量、TC项,差异具有统计学意义(P<0.05);氯氮平组在TG、LDL项,利培酮组在TG项差异具有统计学意义(P<0.01);齐拉西酮组在血脂各项指标上,治疗前后差异无统计学意义(P>0.05)。结论氯氮平、利培酮对患者的血脂代谢均有影响,且氯氮平的影响大于利培酮,齐拉西酮的影响则不显著。  相似文献   

3.
目的:探讨第二代抗精神病药对大鼠血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平与糖脂代谢的影响。方法:将18只SD大鼠随机分为奥氮平组、氯氮平组及对照组;分别给予奥氮平(5 mg/kg·d)、氯氮平(20 mg/kg·d)及生理盐水灌胃56 d。给药前、第28天和第56天分别眼眶静脉采血检测血糖(GLU)、血脂[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)]及血清Lp-PLA2水平,并测量体质量。结果:给药56 d后,奥氮平组GLU、TC、TG、LDL、LpPLA2增幅明显高于对照组,HDL和体质量增幅明显低于对照组(P 0.05或P 0.01);氯氮平组LDL和Lp-PLA2增幅明显高于对照组,HDL和体质量明显低于对照组(P 0.05或P 0.01);给药56 d时奥氮平组血清Lp-PLA2水平与TG正相关(r=0.899,P=0.015)。结论:奥氮平和氯氮平给药均可影响大鼠血清Lp-PLA2水平及糖脂代谢指标,奥氮平给药后Lp-PLA2水平仅与TG显著正相关。  相似文献   

4.
目的 通过观察精神分裂症病人服用氯氮平或利培酮后糖-胰岛素稳态的变化,探讨抗精神病药物与糖代谢的关系。方法 入组病人符合CCMD-3有关精神分裂症的诊断标准,1月内未服用任何抗精神病药物,排除糖尿病等重大躯体疾病史。共入组63例,分入氯氮平组(n=33)和利培酮组(n=30),治疗8周。治疗前后测身高、体重、腰围、空腹血糖、血清瘦素及胰岛素浓度。结果 (1)药物治疗后8周两组病人空腹血糖均略有下降,在利培酮组此种差异已达统计学意义(P=0.049);(2)两组血清胰岛素浓度及胰岛素分泌指数(HOMA-β cell secretion index,HBCI)均升高(P<0.05),治疗后胰岛素浓度与腰围及瘦素浓度相关;(3)胰岛素抵抗指数(HOMA-insulin resistance,HOMA-IR)升高,胰岛素敏感指数(insulin sensitivity index,ISI)下降,在氯氮平组这些差异达统计学意义(P<0.05)。结论 有必要对服用氯氮平或利培酮病人的糖代谢指标进行监测,避免或减轻药物引起的不良反应,提高病人的生活质量。  相似文献   

5.
目的 研究阿立哌唑、奥氮平对首发精神分裂症患者血糖及血脂代谢的影响.方法 随机将61例首发精神分裂症患者分为奥氮平组和阿立哌唑组,比较治疗前及治疗后第6周末两组患者身高、体质量、血糖(FBG)、胰岛素(INS)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯(TG)、总胆固醇(TC)变化.结果 治疗后第6周末奥氮平组FBG、INS、IRI、LDL、TG、TC、体质量及BMI均较治疗前明显升高(P<0.05,P<0.01),治疗后第6周末奥氮平组上述指标较阿立哌唑组高(P<0.05).结论 与奥氮平相比,阿立哌唑对首发精神分裂症患者FBG及血脂代谢影响较轻.  相似文献   

6.
目的 探讨长期应用氯氮平和经典类抗精神病药(APS)对精神分裂症患者体重、血糖和血脂等代谢指标的影响及其可能的相关因素.方法 共调查使用APS≥5年的精神分裂症患者271例,分别测量其身高和体重,检测空腹和餐后2h血糖、空腹血清游离脂肪酸、血清胰岛素和瘦素水平.按药物使用情况将患者分为氯氮平组、经典APS单一治疗组(经典组)或联合用药组进行比较.结果 [1]联合用药组体质量指数、空腹血糖、血甘油三酯和血游离脂肪酸水平均显著高于经典组(P<0.05);血胰岛素和胰岛素抵抗指数也均显著高于经典组和氯氮平组(P<0.05).[2]氯氮平组和联合用药组糖耐量降低和2型糖尿病发生率均明显高于经典组(P<0.05).[3]患者体质量指数与其空腹血糖、血清瘦素、血甘油三酯、胆固醇水平以及与胰岛素抵抗指数均呈正相关(P均小于0.05);患者血清瘦素水平与其血胰岛素水平也呈正相关(P=0.008).[4]多元逐步线型回归分析表明,进入影响空腹血糖水平方程的因素分别为胰岛素抵抗指数、血胰岛素、胆固醇和体质量指数(P<0.05).结论 单用氯氮平及其与经典抗精神病药联用,均易导致患者肥胖,且易导致患者血糖、血脂、血游离脂肪酸水平升高,并与胰岛素抵抗和糖耐量降低发生相关,可能增加2型糖尿病的发生.  相似文献   

7.
目的:研究氯氮平与利培酮对血清脂联素(Adi)等代谢的影响。方法:69例精神分裂症患者随机分为氯氮平组和利培酮组。治疗6周测定患者血清Adi,血脂,空腹血糖、胰岛素水平,计算胰岛素抵抗指数(IR),测量身高、体质量,计算体质量指数(BMI),并与36名正常对照者比较。结果:两患者组治疗后的血清Adi明显降低,氯氮平组血清Adi改变与BMI相关;利培酮组血清Adi改变与IR和利培酮剂量相关。结论:氯氮平与利培酮治疗精神分裂症患者可引起血清Adi降低,并与体质量增加、IR、血脂及利培酮剂量密切相关。  相似文献   

8.
目的评价氯氮平与利培酮对精神分裂症患者血糖、血脂、体重的影响。方法对符合纳入标准的8篇中文文献共555例精神分裂症患者进行meta分析,其中氯氮平组309例,利培酮组246例。依次进行文献质量评价、合并效应量估计与统计推断。结果在研究终点(4~12周),氯氮平组空腹血糖(FBG)、餐后2小时血糖(2hBG)合并效应量大于利培酮组(P<0.05),两组间血清总胆固醇(TCH)、甘油三酯(TG)、体重(BW)、体质量指数(BMI)合并效应量差异均无统计学意义(P>0.05);氯氮平治疗后2hBG、TCH、TG、体重、BMI的合并效应量均大于治疗前(P<0.05),治疗前后FBG合并效应量无改变(P>0.05);利培酮治疗后TCH、TG、体重、BMI合并效应量均大于治疗前(P<0.05),治疗前后FBG、2hBG合并效应量均无改变(P>0.05)。结论利培酮未影响患者血糖,而氯氮平导致患者餐后血糖升高;两者都有可能升高患者血脂,也均可引起患者体重增加。  相似文献   

9.
目的:探讨奥氮平、氯氮平治疗男性精神分裂症患者的疗效及对糖脂代谢的影响。方法:70例男性精神分裂症患者随机分为奥氮平组和氯氮平组各35例治疗8周;采用阳性与阴性症状量表(PANSS)在治疗前后进行评估,同时检测血总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)及空腹血糖(FPG)水平并进行比较。结果:两组PANSS各项评分治疗后均显著下降(P0.05或P0.001);两组间比较差异无统计学意义(P0.05)。两组血TC、TG、LDL交互效应(F=2.932,F=4.159,F=3.911)、TC、LDL、FPG组间主效应(F=4.595,F=4.798,F=5.856)、TC、TG、FPG时间主效应(F=3.224,F=5.389,F=3.979)均存在统计学意义(P0.05或P0.01)。结论:奥氮平与氯氮平治疗男性精神分裂症患者疗效相当;对糖脂代谢均有影响,以奥氮平影响更为明显。  相似文献   

10.
目的:探讨氯氮平对精神分裂症患者体质量(体重)、血脂及胰岛素抵抗的影响。方法:28例氯氮平治疗的精神分裂症住院患者,其中26例完成研究,分别在治疗前和治疗6周末评定阳性与阴性症状量表(PANSS),测量体质量、身高、血糖、血脂、胰岛素及氯氮平药物浓度。结果:与治疗前比较,氯氮平治疗前后体质量指数、三酰甘油水平的增加差异均有显著性(t=-3.181,P=0.004;t=-3.822,P=0.001)。血糖、胆固醇、胰岛素以及胰岛素抵抗等的变化与氯氮平血药物浓度有关。结论:氯氮平可影响精神分裂症患者的体质量指数和血脂水平,氯氮平浓度与胰岛素抵抗有关。  相似文献   

11.
抗精神病药治疗与体质量和血脂等的关系   总被引:1,自引:0,他引:1  
目的:探讨引起住院精神分裂症患者体质量增加的相关因素。方法:首发住院精神分裂症患者72例分别于治疗前和治疗6周末测定体质量、血清瘦素、胰岛素、胰岛素抗体、糖化血红蛋白(HbA1c)、空腹血糖、血清胆固醇(T-CHO)及三酰甘油(TG)。结果:服抗精神病药后体质量有显著性增高(t=7.865,P=0.000)。体质量变化与服药种类(γ=-0.400,P〈0.01)等有关。结论:影响住院精神分裂症患者体质量变化最主要的3个因素为:服用精神药物种类、初始三酰甘油及瘦素变化量。  相似文献   

12.
利培酮对首发精神分裂症患者糖代谢的影响   总被引:1,自引:0,他引:1  
目的:探讨利培酮对首发精神分裂症患者糖代谢的影响.方法:46例首发精神分裂症患者予利培酮治疗,于治疗前和治疗4周末测定空腹血糖(FPG)及餐后2 h血糖(2hPG)、三酰甘油、胆固醇、胰岛素、瘦素、胰岛素抗体,并测量身高、腰围、体质量,计算体质量指数(BMI),量表采用阳性与阴性症状量表(PANSS).结果:治疗第4周末与治疗前相比,2hPG、瘦素、BMI、腰围、血脂、糖耐量异常率明显增高,PANSS总分明显减低.治疗前2hPG与胆固醇、腰围均呈正相关,空腹血糖与BMI呈正相关;治疗4周末2hPG、FPG与腰围均呈正相关.患者年龄、用药剂量是糖耐量异常的有关危险因素.结论:精神分裂症患者在药物治疗的初期就应进行2hPG检测,尤其是年长者和药量较大者.  相似文献   

13.
Weight gain is a common side effect of valproate treatment. The potential mechanisms of valproate-associated weight gain are not yet clear. Decreased blood glucose level, impairment of beta-oxidation of fatty acids, and increased insulin levels are some of the possible mechanisms. The aim of the present study is to evaluate the role of insulin, leptin, and neuropeptide Y in valproate-related weight gain in epileptic children. In 20 epileptic children treated with valproate before treatment and after a follow-up period of 3 and 6 months, body mass index and fasting insulin glucose ratio were calculated and serum glucose, insulin, cortisol, leptin, and neuropeptide Y levels were measured. At the end of 3 months, the mean body mass index values and the mean serum insulin, fasting insulin glucose ratio, and neuropeptide Y levels increased, whereas the serum glucose levels decreased. After 6 months of treatment, the mean serum cortisol and leptin levels were high, in addition to the body mass index, neuropeptide Y, and fasting insulin glucose ratio. These results suggest that weight gain during valproate treatment might be related to low glucose and high insulin, cortisol, leptin, and neuropeptide Y levels.  相似文献   

14.
We aimed to determine the importance of leptin in the regulation of luteinizing hormone (LH) and growth hormone (GH) secretion in ovariectomized (OVX) ewes. Lean and fat sheep were produced by dietary manipulation over 8 months and were then fasted for 32 h. Plasma concentrations of glucose, insulin and leptin were higher in the fat group. Fasting decreased plasma concentrations of glucose and insulin and increased concentrations of nonesterified fatty acids (NEFA) in fat and lean ewes, but leptin concentrations were reduced in the fat group only. Plasma GH concentrations were higher in the lean group and LH concentrations were lower; there was no effect of fasting. These data suggested that long-term changes in plasma leptin concentrations might affect LH and GH secretion, but acute changes with fasting had no effect. OVX ewes of normal body weight were fasted for 72 h with or without intracerebroventricular (i.c.v.) infusion of leptin (4 microg/h), achieving similar metabolic effects to the 32 h fast. The 72-h fast increased LH pulse amplitude, mean GH and cortisol concentrations, but these changes were corrected towards normal by leptin treatment. Thus, leptin could attenuate fasting-induced alterations in the secretion of LH, GH and cortisol. Finally, we food-restricted OVX ewes for 4 months (lean), leading to a 20-kg reduction in body weight. Plasma concentrations of leptin and insulin were decreased, and plasma GH concentrations increased, but there was no effect on plasma concentrations of LH, glucose or NEFA. Icv infusion of leptin did not affect any endocrine or metabolic parameter in these ewes. In summary, maintenance of a lean or fat condition for a prolonged period (8 months) or an extended fasting (72 h) can affect LH and GH secretion, but short-term food restriction (4 months) affected only GH secretion and short-term fasting (32 h) had no effect on either LH or GH secretion. This is in spite of altered plasma leptin concentrations in all circumstances studied. Although leptin treatment can restore plasma concentrations of LH, GH and cortisol towards normal in sheep fasted for 72 h, some other factor(s) must signal to the brain to cause shifts in neuroendocrine function in other conditions where nutritional/metabolic status is altered.  相似文献   

15.
首发抑郁症患者糖脂代谢研究   总被引:1,自引:0,他引:1  
目的:探讨首发抑郁症患者的糖脂代谢情况。方法:对80例首发抑郁症患者及40名健康对照者先进行简易体脂参数的测量,然后进行糖耐量试验(OGTT),并检测其空腹血浆胰岛素、三酰甘油(TG)、总胆固醇(TC)的浓度。结果:体脂参数、空腹血浆胰岛素的浓度、餐后0、1、3h血糖值,两组间差异均无显著统计学意义(P均>0.05);抑郁症组空腹血糖值(FBS)、餐后2h的血糖值、OGTT血糖曲线下面积(AUC)、TG值明显高于对照组(P<0.01);而高密度脂蛋白(HDL-c)、载脂蛋白A1(ApoA1)值抑郁症组明显低于对照组(P<0.01),TC、低密度脂蛋白胆固醇(LDL-c)和载脂蛋白B(ApoB)值两组间差异均无统计学意义(P均>0.05);两组糖耐量减退(IGT)的发生率差异有统计学意义(P<0.05),抑郁症组IGT发生率较对照组高。结论:首发抑郁症患者存在一定的糖脂代谢异常,临床医师应该对抑郁症患者的血糖、血脂进行随访监测,以便早期发现、治疗糖脂代谢性疾病。  相似文献   

16.
目的 探讨氯氮平、氟哌啶醇和氯丙嗪对慢性精神分裂症患者的糖、脂代谢和体质量的影响。方法 对服用氯氮平(89例,氯氮平组),服用氟哌啶醇(87例,氟哌啶醇组)及服用氯丙嗪(83例,氯丙嗪组)治疗的慢性精神分裂症患者于治疗前后的不同时间进行血糖、胰岛素、血脂及体质量测定,并做相关因素分析。结果 氯氮平组治疗第90天和第180天空腹血糖异常(空腹血浆血糖〉7.0mmo/L)的发生率分别为8%及24%,氟哌啶醇组分别为1%和2%,氯丙嗪组分别为1%及4%。治疗第90天氯氮平组和氯丙嗪组的空腹及餐后2h血糖浓度均较治疗前升高,治疗第180天的血糖浓度高于第90天,氟哌啶醇组各时点的变化则不明显;差异均有统计学意义(P均〈0.01)。治疗第90天,氯氮平组的体质量平均高于治疗前5.5%,氯丙嗪组高于治疗前4.8%;治疗第180天两组分别高于治疗前9.1%和7.4%;氟哌啶醇组则无明显变化;三组间的差异有统计学意义(P〈0.01)。三组患者治疗第180天的胰岛素浓度均高于治疗前,差异均有统计学意义(P均〈0.01),但三组间的差异无统计学意义(P〉0.05)。氯氮平组和氯丙嗪组的胆固醇和甘油三酯浓度均高于治疗前,差异均有统计学意义(P均〈0.01),氟哌啶醇组则无明显变化。治疗第180天氯氮平组和氯丙嗪组患者血糖、胰岛素、血脂浓度与体质量均有一定相关性(r=0.23-0.39);氯氮平组的血糖、体质量、血脂代谢还与血药浓度呈显著性相关(r=0.28-0.62),差异均有统计学意义(P〈0.05或〈0.01)。结论 氯氮平和氯丙嗪治疗影响慢性精神分裂症患者的糖、脂代谢及体质量。  相似文献   

17.
Risperidone has a relatively low risk of causing obesity and diabetes mellitus and is a first-line treatment for schizophrenia. The aim of the present study was to investigate glucose and lipid metabolism, and feeding-control parameters in schizophrenia patients treated with long-term risperidone monotherapy. Fifteen patients with paranoid-type schizophrenia who had been treated with risperidone and had Global Assessment of Function (GAF) scores >70 were selected and compared with healthy volunteers (n = 25). Single assessments of psychotic symptoms, side-effects, Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) score, bodyweight, body fat percentage and blood sampling were performed. Fasting blood glucose, insulin, hemoglobin A1c, homeostasis model assessment insulin resistance index (HOMA-IR), total cholesterol, triglyceride, high density lipoprotein (HDL)-, low density lipoprotein-cholesterol, adiponectin, prolactin and feeding-control parameters (ghrelin and leptin) were analyzed. The body fat percentage (P = 0.0018), body mass index (BMI) (P = 0.0150), fasting blood glucose (P = 0.0358), triglyceride (P = 0.0377), leptin (P = 0.0243), total ghrelin (P = 0.0067), active ghrelin (P = 0.0241) and prolactin (P < 0.0001) levels of patients treated with risperidone were significantly higher than those of healthy volunteers, while the HDL-cholesterol level (P = 0.0222) was significantly lower. Although the patients had very mild psychiatric symptoms and maintained functionally high levels, the glucose and lipid parameters were significantly impaired compared to healthy volunteers. A high level of plasma ghrelin might increase appetite, leading to exacerbation of metabolic impairment.  相似文献   

18.
OBJECTIVE: To assess whether metformin prevents body weight gain (BWG) and metabolic dysfunction in patients with schizophrenia who are treated with olanzapine. METHOD: Forty patients taking olanzapine (10 mg daily) were randomly allocated to a metformin (n = 20; 850 to 1700 mg daily) or placebo (n = 20) group in a 14-week double-blind study. Waist circumference (WC), BWG, body mass index (BMI) fasting glucose, insulin, and lipids were evaluated at baseline and at Weeks 7 and 14 of treatment. RESULTS: At Week 14, BWG (kg) was similar in the metformin group (5.5 kg) and the placebo group (6.3 kg), P = 0.4. There were no differences between the changes in BMI, WC, glucose, insulin, insulin resistance index (HOMA-IR), and plasma lipid levels observed in the treatment group and the placebo group; however, glucose levels decreased significantly after metformin administration (P = 0.02). The HOMA-IR decreased significantly in both groups, but 3 subjects from the placebo group developed fasting glucose levels greater than 5 mmol/L. After taking metformin, triglyceride levels increased, but the cholesterol profile improved significantly. CONCLUSIONS: Metformin did not prevent olanzapine-induced BWG. While some lipid parameters worsened during placebo, the HOMA-IR improved in both the placebo and the metformin groups. Carbohydrate metabolism impairment was not systematically observed during short-term olanzapine administration.  相似文献   

19.
氯丙嗪与奎硫平对血脂和血糖的影响   总被引:4,自引:0,他引:4  
目的:研究氯丙嗪与奎硫平对精神分裂症患者血脂与血糖的影响。方法:130例精神分裂症患者随机分为氯丙嗪组(65例)与奎硫平组(65例),治疗8周。所有患者于治疗前与治疗4、8周测空腹血糖、总胆固醇、三酰甘油和体质量(体重)。结果:氯丙嗪组总胆固醇、三酰甘油、体质量在治疗第4、8周均较治疗前显著升高(P<0.01);奎硫平组三酰甘油、体质量在治疗第4、8周均较治疗前显著升高(P<0.01)。治疗8周后,两组男性患者总胆固醇与空腹血糖较治疗前均显著升高(P<0.01),女性患者三酰甘油与总胆固醇治疗后较治疗前显著升高(P<0.01)。结论:氯丙嗪与奎硫平对血脂和血糖的影响不同,2药对血脂与血糖的影响存在性别差异。  相似文献   

20.
目的探讨奋乃静、利培酮对中老年精神分裂症患者体质量、糖脂代谢、催乳素及肿瘤坏死因子α的影响。方法将49例中老年精神分裂症患者随机分为奋乃静组(23例)和利培酮组(26例),共治疗8周.所有患者于疗前和治疗8周后测定体质量、空腹血糖、胰岛素、血脂和肿瘤坏死因子α水平。奋乃静组19例和利培酮组21例完成疗前和治疗8周后血清催乳素测定。结果治疗8周后,奋乃静组和利培酮组体质量、血清催乳素水平均显著增加,前组甘油三酯水平显著增高,后组高密度脂蛋白和空腹血糖水平显著降低。两组胰岛素、胰岛素抵抗及血清肿瘤坏死因子水平治疗8周前后无显著性差异。结论奋乃静和利培酮均可导致中老年精神分裂症患者体质量、血清催乳素水平显著增加,但两种药物对糖脂代谢的影响并不相同。  相似文献   

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