非典型抗精神病药对精神分裂症患者血脂影响的对比研究

目的：比较非典型抗精神病药对精神分裂症患者脂质代谢的影响.方法：前瞻性调查应用非典型抗精神病药的患者150例,其中氯氮平40例,奥氮平30例,利培酮40例,奎硫平40例.比较用药前后血脂的变化,并分析与血脂有关的几个因素（剂量、体重、心电图变化）的关系.结果：四种非典型抗精神病药治疗后,患者TG水平明显升高,治疗后8周较4周更显著（P〈0.01）,HDL水平明显降低（P〈0.05或0.01）;药物剂量与TG水平呈正相关（P〈0.05）;治疗8周后体重增加与血清TG无明显相关关系（P〉0.05）;心电图呈心肌缺血改变组（氯氮平组、奥氮平组）的TG水平明显高于正常组（P〈0.05）,而利培酮组、奎硫平组差异不显著（P〉0.05）.结论：四种非典型抗精神病药物治疗后可引起血脂异常,且异常的血脂可能与心肌损伤有关,但短期内未见与体重有关.

The Effect of Atypical Antipsychotics on Blood-Lipid Metabolism of Patients with Schizophrenia

Objective:To explore the effect of atypical antipsychotics on blood-lipid metabolism of Patients with Schizophrenia.Methods:150 schizophrenic patients were randomly divided into Clozapine group(n=40),Olanzapine group(n=30),Risperidone group(n=40)and Quetiapine group(n=40),Their blood lipid were measured before and after medication.The relation of some factors (dosages,weight,ECG)to blood lipid were also analysised.Results:After treatment,TG levels were increased significantly(P<0.05),especially at the end of 8th week(P<0.01),but HDL levels decreaded(P<0.05 or 0.01);The dosage of antipsychotics had positive correlation with plasma TG;At the end of 8th week weight gain had no correlation with plasma TG(P>0.05);plasma TG levels in patients(Clozapine group,Olanzapine group) with abnormal ECG were higher than those with normal ECG(P<0.05),but TG levels on Risperidone or Quetiapine groups had no differences(P>0.05).Conclusions:The Four kinds of atypical antipsychotical treatment may cause abnormal blood-lipid level and then myocardial damage,but no weight gain in short term.