利培酮和氯氮平对60例精神分裂症糖脂代谢的影响

目的：研究利培酮和氯氮平对糖脂代谢的影响。方法：60例精神分裂症患者根据临床治疗需要分为氯氮平组（30例）和利培酮组（30例），治疗观察4周。每组患者于治疗前后测空腹血糖、甘油三脂、胆固醇、空腹胰岛素、空腹C肽，量身高、体重、腰围、臀围，并计算体重指数（BMI）及胰岛素抵抗指数（IR）。结果：（1）治疗后两组患者的胰岛素、C肽、IR均升高，与治疗前的差异有统计学意义（P〈0.05）；治疗后氯氮平组患者的甘油三脂、胆固醇均明显高于治疗前（P〈0．05）；（2）治疗后BMI、胰岛素、C肽、甘油三脂、胆固醇、IR的升高程度氯氮平大于利培酮，差异均有显著性（P〈0.05）。结论：氯氮平对糖代谢及脂代谢的影响大于利培酮。

The side-effects of clozapine and risperidone on the glucose metabolism and lipid metabolism

Objective:To study the side-effects of clozapine and risperidone on the glucose metabolism and lipid metabolism in schizophrenic patients.Methods:Sixty schizophrenic patients were divided into clozapine group and risperidone group.Before and after four-week treatment,some data which include height,body weight,chest(abdomen) circumference,buttock circumference,the fasting blood glucose,the fasting insulin,C-peptide,cholesterol and triglyceride were measured.In addition,the body mass index(BMI) and insulin resistance(IR) were calculated.Results: After treatment,the fasting serum insulin,C-peptide and IR levels increased significantly in two groups.Cholesterol and triglyceride concentration significantly increased in clozapine group.The increased level of BMI,the fasting insulin,C-peptide,cholesterol,triglyceride and IR was clozapine >risperidone.Conclusions: The effects of clozapine on the glucose metabolism and lipid metabolism outweigh those of risperidone.