糖化血红蛋白预测抗精神病药对糖代谢的影响

目的：探讨抗精神病药（APS）对糖代谢的影响，及糖化血红蛋白（HbA1c）检查预测APS所诱发糖代谢疾病的可行性。方法：对85例接受APS治疗的精神分裂症患者，检测治疗前HbA1c,治疗前及治疗后6周的空腹血糖（FPG）、糖耐量试验2h血糖（2HPG）。结果：治疗前、后FPG差异无显著性，治疗后2HPG较治疗前增高；HbA1c异常组在治疗前、后2HPG均高于正常组；HbA1c值与治疗前、后2HPG间均有正相关；HbA1c异常组APS治疗后，出现糖代谢疾病危险的比值比（OR）为14。结论：APS使用后出现的糖代谢异常以2HPG的改变为主，HbA1c异常者2HPG．较高，可能存在糖代谢功能的缺陷，易受APS的影响而出现糖代谢疾病。

Forecast of influence of antipsychotics on sugar metabolism with glycated hemoglobin A1C

Objective:To detect influence of antipsychotics on sugar metabolism,and possiblity of glycated hemoglobin A_(1C)(HbA_(1C)) to predict sugar metabolism disorder associated with antipsychotics. Method:HbA_(1C),the fasting plasma glucose(FPG) and 2-hour plasma glucose in the oral glucose tolerance test(2HPG) before and after the study were measured in 85 cases with schizophrenia who were assigned to antipsychotics treatment for 6 weeks. Results:FPG showed no significant difference between the baseline and end of the treatment,while 2HPG was significantly higher at the end than at the baseline.2HPG before and after the study were higher in abnormal HbA_(1C) group than in normal HbA_(1C) group.A positive correlation was found between HbA_(1C) and 2HPG before and after the treatment.The vaule of risk odds ratio(OR)of suffering sugar metabolism disorder infected by antipsychotics treatment was 14. Conclusion:The main sugar metabolism abnormality after antipsychotic treatment is the change of 2HPG.Abnormal HbA_(1C) cases have a higher 2HPG status.They might have a sugar metabolism deficiency and are easier to develop a sugar metabolism disorder.