二甲双胍对住院精神分裂症伴糖耐量减低患者干预的3年随访

目的:观察二甲双胍干预对糖耐量减低(IGT)的住院精神分裂症患者糖尿病发病率的作用. 方法:对符合《中国2型糖尿病防治指南2007》诊断标准的78例IGT住院精神分裂症患者,随机分为对照组、饮食+运动组和二甲双胍组,每组26例,随访观察3年. 结果:初访时3组基线资料无统计学差异.3年末,对照组糖尿病发生率为73.1％( 19/26);饮食加运动组为45.5％ (10/22);二甲双胍组为16.7％ (4/24),组间存在统计学差异(X2=15.998,P=0.000),二甲双胍组与对照组比较,存在统计学差异(X2=15.987,P=0.000);二甲双胍组与饮食加运动组比较,存在统计学差异(X2=4.493,P=0.034);饮食加运动组与对照组比较,无统计学差异(X2=3.802,P=0.051).二甲双胍组3年末糖化血红蛋白( GHbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)与饮食+运动组和对照组比较均存在统计学差异(P＜0.05). 结论:二甲双胍与行为干预单一或联合治疗均对减轻精神分裂症患者IGT发展到糖尿病(DM)可能有一定效果,二甲双胍联合行为干预的疗效更好.

The preventive effect of metformin on schizophrenic inpatients with impaired glucose tolerance from becoming diabetes mellitus:a 3-year follow up study

Objective:To observe the effect of metformin interventions on schizophrenic inpatients with impaired glucose tolerance(IGT).Method:In this 3-year prospective study,78 subjects with IGT were included.The criteria of IGT was based on the prevention of type 2 diabetes in China Guide 2007.The subjects were divided into control(C),diet plus exercise(D+E) and metformin(M) groups,26 subjects in each group.Results:The baseline data of 3 groups had no statistical differences.By the end of study,the diabetes incidence was 73.1%(19/26) in group C,45.5%(10/22) in group D+E and 16.7%(4/24) in group M.There was significant difference in 3 groups(χ2=15.998,P=0.000),and there was significant difference between group M and group C(χ2=15.987,P=0.000);also between group M and group D+E(χ2= 4.493,P=0.034);Metformin treatment was associated with improvement of fasting insulin,glycosylated hemoglobin and HOMA-IR were also decreased with significance difference compared with group C and group D+E(P<0.05).Conclusion:Either of(or both) metformin and behavior intervention may prevent to a certain extent schizophrenic patients with IGT from diabetes mellitus,and both metformin(and) behavior have better efficacy.