丙戊酸钠与碳酸锂对躁狂发作患者体质量、神经肽Y、瘦素影响的研究

目的探讨丙戊酸钠、碳酸锂治疗对躁狂发作患者体质量、神经肽Y、瘦素的影响及其相互关系。方法 80例躁狂发作患者,随机分组后分别接受丙戊酸钠、碳酸锂治疗。观察治疗前、治疗2、4周末体质量、神经肽Y、瘦素的变化。结果丙戊酸钠组体质量4周末显著高于0周(t=2.078,P=0.046),神经肽Y4周末显著高于2周末、0周(t=2.286,P=0.029;t=3.620,P=0.001)。碳酸锂组体质量、神经肽Y在各时点无显著变化(t=0.477～1.173,P=0.515～0.256;t=0.873～1.237,P=0.424～0.193)。两组的瘦素虽有增高趋势,但差异均无显著性(t=1.148～1.355,P=0.259～0.185;t=0.895～1.292,P=0.431～0.190)。4周末丙戊酸钠组神经肽Y变化值与体质量增加呈正相关(r=0.396,P=0.022)。结论丙戊酸钠可致躁狂发作患者体质量增加和神经肽Y、瘦素升高,但以前两者为著,且神经肽Y的升高与体质量增加有相关性。

Effects of Sodium Valproate and Lithium on Body Weight ,Neuropeptide Y and Leptin of Patients with Manic Episode

Objective To investigate the changes of NPY,leptin,body weight of patients with manic episode with sodium valproate and lithium treatment and their relationship.Methods A total of 80 subjects with manic episode were randomly divided into two groups and treated with sodium valproate or lithium for 4 weeks.Body weight and NPY,leptin levels were dynamically monitored pre and pro-treatment.Results In sodium valproate group,body weight began to rise significantly at week 4（t=2.078,P=0.046）,and NPY level at week 4 was higher than that at week 2,week 0（t=2.286,P=0.029;t=3.620,P=0.001）.The differences of body weight and plasma neuropeptide Y level at each time point in lithium group were not significant（t=0.477~1.173,P=0.515~0.256;t=0.873-1.237,P=0.424~0.193）.In both groups,the leptin levels showed no significantly changing during the study（t=1.148~1.355,P=0.259~0.185;t=0.895~1.292,P=0.431~0.190）.In sodium valproate group,the alteration of body weight at 4 weekend was positively correlated with that of plasma neuropeptide Y level（r=0.396,P=0.022）.Conclusion The data indicates that NPY,leptin are elevated and body weight is increased in the treatment with sodium valproate,moreover,the increasing of NPY level have a significant relationship with that of body weight.