非典型与典型抗精神病药物对老年精神分裂症患者的体重、血糖及血脂影响的对照研究

目的探讨非典型抗精神病药物奥氮平、利培酮及喹硫平与典型抗精神病药物奋乃静对老年精神分裂症患者的体重、血糖及血脂等的影响。方法住院的126例老年精神分裂症患者,选择非经典抗精神病药物利培酮治疗的33例,奥氮平治疗的40例,奎硫平治疗的25例;选择经典的抗精神病药物奋乃静治疗的28例,在12周的治疗的不同时期观察体重、体重指数、腹围、血糖及血脂的变化,同时对四组之间进行以上数据的比较研究。结果四组患者治疗前后体重、体重指数及腹围的增加具有显著性意义,而血脂等变化没有显著性意义;使用非典型抗精神病药物较典型抗精神病药物更容易引起体重及体重指数的增加。而非典型的抗精神病药物中,奥氮平组的体重及体重指数增加较利培酮及喹硫平更加明显。结论非经典抗精神病药物与经典抗精神病药物都会引起老年精神分裂症患者部分代谢指标的变化,非经典药物,特别是奥氮平对体重、体重指数等的影响要引起重视。

Compare the effects of none- / typical antipsychotic drug on weight gain,blood glucose level and bloodfat in geriatric schizophrenic inpatients

Objective The purpose of this study was to investigate the changes in body weight and levels of fasting glucose and blood fat in geriatric schizophrenia inpatients that were treated with olanzapine,risperidone,quetiapine or perphenazine. Methods One hundred and twenty- six geriatric inpatients with schizophrenia were randomly divided into four groups,33 patients were treated with olanzapine,40 of them were treated with risperidone,25 patients received quetiapine and 28 were treated with perphenazine,the treatment lasted for 12 weeks. Measured the indexes including body weight,body mass index（ BMI）,waist circumference,levels of fasting glucose and blood fat in patients and compared. Results Body weight,waist circumference and BMI of all the four groups were increased significantly,but the levels of blood fat were not changed. None- typical antipsychotic drugs were more likely to cause increasing in body weight and body mass index（ BMI）,what ＇s more,olanzapine present more effective than others. Conclusions Both atypical and typical antipsychotic medications could cause changes in metabolic indexes, and we should pay extra attention on an atypical antipsychotic drug- olanzapine.