酚噻嗪类药物对精神分裂症患者血清载脂蛋白、脂蛋白含量的影响

目的:探讨长时间(1月-25年)接受酚噻嗪类药物治疗后的精神分裂症患者引起血脂代谢紊乱的危险因素及其临床意义。方法:采用酶法、免疫透射比浊法检测了120例慢性精神分裂症患者、50例血管性痴呆患者和100例健康体检者血总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白AI(ApoAl)、载脂蛋白B(ApoB)的水平.结果:精神分裂症、血管性痴呆患者血ApoAI,HDL-C,ApoAI/ApoB含量明显低于健康对照组(P<0.01),ApoB、TG水平分别显著高于健康对照组(P<0.01),其中阴性症状组和血管性痴呆组TG含量明显高于阳性症状组(P<0.01),而三组病人TC的水平与正常对照组相比差异无显著性(P>0.05)。结论:长时间服用酚噻嗪类药物治疗后的慢性精神分裂症患者存在着血脂代谢紊乱,应在治疗精神分裂症的同时服用降脂、降粘、扩血管等药物,以预防和降低诱发心、脑血管病的危险因素,并达到延缓和推迟患者智能障碍以及痴呆的发展。

Effects of phenothiazine drugs on serum levels of apolipoproteins and lipoproteins in schizophrenic subjects

AIM: To investigate the risk factors and clinical significance of blood-lipid metabolic disorder in schizophrenic patients caused by phenothiazine treatment for long term(from 1 month to 25 years). METHODS: Serum levels of apolipoprotein AI(apoAI), apolipoprotein B(apoB), high-density lipoprotein cholesterol(HDL-C), triglyceride(TG), and total cholesterol(TC) were measured in 120 chronic schizophrenia patients, 50 vascular dementia, and 100 normal controls by the enzyme method and immune fluoroscopy turbidimetric method. RESULTS: The patients with schizophrenia and vascular dementia had significantly lower content of apoAI, HDL-C, and apoAI/apoB than those in normal control(P<0.01). Their apoB and TG levels were higher than the healthy control group(P<0.01). The TG contents in the negative group and the vascular dementia group were obviously higher than the positive group(P<0.01) while there was no marked difference between the TC levels in the three groups and the normal control group(P>0.05). CONCLUSION: The chronic schizophrenic patients have a blood-lipid metabolic disorder by long-term intake of phenothiazine drugs. It is suggested that the traditional treatment with antipsychotic should reformed, and that drugs of degrading lipid and coagulation should be used to prevent and reduce the risk factors causing the onset of cardiovascular and cerebrovascular diseases and delay the development of the disturbance of intelligence and dementia.