奥氮平与阿立哌唑对精神分裂症患者体质量、血浆神经肽Y及瘦素影响的比较

目的:比较奥氮平和阿立哌唑对精神分裂症患者体质量、血浆神经肽Y及瘦素水平的影响。方法:60例精神分裂症患者随机分为奥氮平组和阿立哌唑组各30例分别治疗8周。在治疗前、治疗后4周和8周测定两组体质量、血浆神经肽Y和瘦素水平并进行治疗前后比较。结果:奥氮平组在治疗4周和8周时体质量(F=287.207,F=506.777)、血浆神经肽Y水平(F=725.697,F=5152.624)明显高于治疗前(P均=0.000);瘦素水平治疗4周时与治疗前差异无统计学意义(F=3.908,P=0.058),治疗8周时高于治疗前(F=1589.726,P=0.000)。阿立哌唑组治疗4周和8周时体质量(F=2.810,F=1.819)、血浆神经肽Y(F=0.232,F=0.376)及瘦素水平(F=0.975,F=1.295)与治疗前比较差异无统计学意义(均P0.05)。奥氮平组治疗4周和8周时体质量的变化与神经肽Y的变化明显正相关(r=0.632,r=0.576;均P0.001),与瘦素的变化无相关(r=0.254,r=0.085;P均0.05)。逐步回归分析显示,奥氮平组神经肽Y变化进入以体质量变化为因变量的回归方程,治疗4周和8周时,神经肽Y变化可以解释体质量变化变异的40.0%和33.1%。结论:与阿立哌唑相比,奥氮平能显著增加精神分裂症患者体质量;血浆神经肽Y水平的变化可能是体质量增加的原因之一。

Body weight,neuropeptide Y and leptin in schizophrenia patients with olanzapine and aripiprazole treatment

Objective:To explore the impact of olanzapine and aripiprazole treatment on the body weight,neuropeptide Y and leptin in schizophrenia patients. Method:Sixty patients with schizophrenia were randomized into the olanzapine group(n = 30)and the aripiprazole group(n = 30),accepted the olanzapine or aripiprazole treatment respectively,the body weight,plasma level of neuropeptide Y and leptin were measured at baseline and at the 4th,8th weekend of the treatment. Results:The body weight(F = 287. 207,F = 506. 777) and plasma neuropeptide Y level(F = 725. 697,F = 5152. 624)in olanzapine group increased at the 4th,8th weekend of the treatment(P = 0. 000). There was no significant difference in leptin at the 4th weekend of the treatment while the level of leptin increased at the 8th weekend(F = 3. 908,P = 0. 058,F = 1589. 726,P =0. 000). There were no significant differences in body weight(F = 2. 810,F = 1. 819),plasma level of neuropep-tide Y(F = 0. 232,F = 0. 376)and leptin(F = 0. 975,F = 1. 295)among three time-points in aripiprazole group (P > 0. 05). The altering rate of body weight in olanzapine group was positively correlated with the altering rate of neuropeptide Y at the 4th weekend,8th weekend(r = 0. 632,r = 0. 576;all P < 0. 001). There was no signifi-cant correlation between the altering rate of body weight and the altering rate of leptin in olanzapine group(r =0. 254,r = 0. 085;all P > 0. 05). Multiple Logistic regression analysis revealed that altering rate of neuropeptide Y was one of risk factors of the altering rate of body weight with the altering rate of neuropeptide Y and leptin as independent variables,that altering rate of body weight as the dependent variable. The altering rate of neuropep-tide Y explained 40. 0% of variance of intention of the altering rate of body weight at the 4th weekend,and 33. 1% at the 8th weekend. Conclusion:Olanzapine significantly increased body weight in schizophrenia pa-tients,the altering rate of neuropeptide Y may one of reasons of weight gain in schizophrenia patients.