利拉鲁肽在口服抗精神病药所致糖脂代谢紊乱老年患者中的应用

目的:探讨利拉鲁肽对老年人群口服抗精神病药所致糖脂代谢紊乱的作用.方法:选取2018年12月至2019年12月应急总医院门诊及住院病房使用奥氮平或氯氮平的老年精神障碍患者100例,随机分为研究组和对照组,每组50例.研究组患者给予16周的利拉鲁肽治疗,对照组患者进行生活方式干预.比较两组患者治疗前后体重、腰围、血压、血...

Application of Lialulutide in Elderly Patients with Glucose and Lipid Metabolic Disorders Induced by Oral Antipsychotics

OBJECTIVE:To probe into the effects of lialulutide in elderly patients with glucose and lipid metabolic disorders induced by oral antipsychotics.METHODS:A total of 100 elderly patients with mental disorders who were given olanzapine or clozapine from Dec.2018 to Dec.2019 in outpatient and inpatient departments of Emergency General Hospital were randomly divided into the study group and the control group,with 50 cases in each group.Patients in the study group were treated with liraglutide for 16 weeks,while the control group received lifestyle intervention.Changes in body weight,waist circumference,blood pressure,blood glucose,pancreaticβfunction,total cholesterol and low density lipoprotein-cholesterol levels before and after treatment in two groups were compared.RESULTS:After 16 weeks of liraglutide treatment,the weight[(-5.4±0.9)kg,P<0.001],waist circumference[(-4.9±0.7)cm,P=0.002],systolic blood pressure[(-4.8±2.0)mm Hg(1 mm Hg=0.133 kPa),P=0.004],total cholesterol[(-0.51±0.09)mmol/L,P=0.02],low density lipoprotein-cholesterol[(-0.39±0.08)mmol/L,P=0.015],and fasting blood glucose[(-1.4±0.8)mmol/L,P=0.020]in the study group were significantly lower than before treatment,and were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Compared with before treatment,the pancreaticβ-cell function indicators(23.43±3.18,P<0.001)of the study group increased significantly,and the insulin resistance indicators(-1.46±0.34,P<0.001)decreased significantly.Compared with the control group,the pancreaticβfunction of the study group was significantly improved,and the difference was statistically significant(P<0.05).CONCLUSIONS:Liranutide can effectively resist glucose and lipid metabolic disorders induced by oral antipsychotics,improve pancreaticβfunction and insulin resistance,significantly reduce body weight and blood glucose levels,and delay the occurrence and development of type 2 diabetes in elderly patients with mental disorders.