氯氮平奥氮平利培酮对精神分裂症患者脂代谢及体质量的影响

目的 探讨氯氮平、奥氮平、利培酮对精神分裂症患者脂代谢及体质量的影响,为临床安全用药提供依据.方法 将120例男性精神分裂症患者随机分为氯氮平组、奥氮平组和利培酮组,每组40例,分别口服氯氮平、奥氮平、利培酮治疗,观察8周.于治疗前及治疗4周、8周末分别检测血脂、体质量,并计算体质量指数.结果 治疗各时段3组血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇、载脂蛋白B水平均较治疗前显著升高,以氯氮平组升高最为显著(P＜0.05或0.01);治疗8周末氯氮平组高密度脂蛋白胆固醇水平较治疗前显著下降(P＜0.01),利培酮组和奥氮平组则无显著变化(P＞0.05).治疗后氯氮平组体质量及体质量指数较治疗前显著升高(P＜0.01),治疗8周末有下降趋势,但仍显著高于治疗前(P＜0.01);奥氮平组和利培酮组治疗前后虽有变化,但差异均无显著性(P＞0.05).结论 氯氮平、奥氮平和利培酮对精神分裂症患者血脂代谢均有不同程度的影响,但氯氮平对血脂和体质量影响最显著,奥氮平和利培酮影响较小,因此,对服用氯氮平治疗的患者应定期监测血脂和体质量.

Influences of clozapine, olanzapine and risperidone on lipid metabolism and body mass of schizophrenia

Objective To explore the Influences of clozapine, olanzapine and risperidone on lipid metabolism and body mass of schizophrenia in order to provide basis for clinical safe medication. Methods 120 male schizophrenics were randomly assighed to three groups of 40 patients each and took orally clozapine, olanzapine or risperidone respectively for 8 weeks. Blood fat and body mass were detected before treatment and at the end of the 4th and 8th week and body mass index （BMI） computed. Results In each period of treatment, total cholesterol, triacylglycerol, LDL-ch and apoprotein B levels of three groups heightened more significantly compared with pretreatment, and those of clozapine group did most （P〈0.05 or 0.01） ; at the end of the 8th week HDL-c levels of clozapine group lowered more significantly compared with pre treatment （P〈0.01）, those had no singificant changes in risperidone and olanzapine group （P〈0.05）. After treatment body mass and BMI in clozapine group heightened more significantly compared with pre treatment （P〈0.01）, at the end of the 8th week those showed downtrend, but were still significantly higher （P〈0.01）; although body mass and BMI in olanzapine and risperidone had changes, differences were not significant （P〈0. 05）. Conclusion C）ozapine, olanzapine and risperidone all influence blood fat metabolism in different degree, but clozapine influence is the most, olanzapine and risperidone are less, therefore blood fat and body mass are periodically detected for patients receiving clozapine treatment.