氯氮平、利培酮与齐拉西酮对精神分裂症患者血药浓度与脂代谢的影响研究

目的探讨氯氮平、利培酮、齐拉西酮三种抗精神病药物对精神分裂症患者治疗过程中血药浓度与体重及脂代谢的影响。方法将符合CCMD-3精神分裂症诊断标准的187例精神分裂症患者随机分成氯氮平、利培酮、齐拉西酮三组,分别给予单药治疗6个月。于治疗前及治疗第1、2、3、6个月末监测患者血药浓度(PDL)、血脂中总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)等项指标,同时采用阳性与阴性症状量表(PANSS)评定患者的临床症状及疗效。结果治疗后较之治疗前,氯氮平组、利培酮组随血药浓度在治疗范围内增加而血脂各项指标数值均有不同程度的增加,且在体重、血脂中总胆固醇(TC)项差异有统计学意义(P<0.05);氯氮平组在甘油三酯(TG)、低密度脂蛋白(LDL)项,利培酮组在甘油三酯(TG)项差异有显著性意义(P<0.01)。齐拉西酮组随血药浓度在治疗范围内增加而体重及血脂各项指标在治疗前、后差异无统计学意义(P>0.05)。结论氯氮平、利培酮的血药浓度在治疗范围内增加对患者的体重及血脂代谢均有影响,且氯氮平的影响大于利培酮;齐拉西酮的血药浓度在治疗范围内增加对患者的体重及血脂代谢影响不明显。

Research on influnce of Ziprasidone and clozapine risperdal in treatment of patients with schizophrenia,blood drug concentration and lipid metabolism

Objective To explore the influnce of clozapine,risperdal,ziprasidone three antipsychotic drugs on patients with schizophrenia treatment process blood drug concentration and weight and the lipid metabolism.Methods Totally 187 cases of schizophrenia patients in accord with CCMD-3 schizophrenia diagnosis standard were randomly divided into clozapine,risperdal,ziprasidone three group,who were given single drug treatment for 6 months.In the treatment,and treatment before 1,2,3 and 6 months end monitor patients blood drug concentration(PDL),total cholesterol in the blood fat(TC),triglycerides(TG),high-density lipoprotein(HDL),low density lipoprotein(LDL),and other indicators,and at the same time with the positive and negative symptoms scale(PANSS) to assess the clinical symptoms and curative effect.Results After treatment compared with that before treatment,clozapine group,risperidone groups with blood drug concentration in the treatment of range increased blood fat and the index increased value,and in weight,TC item,a statistically significant difference(P<0.05);Clozapine group(TG,LDL),risperidone groups TG with significant difference(P<0.01).Ziprasidone group with blood drug concentration increase in the treatment of range,weight and the index of blood lipid before and after treatment was not statistically significant difference(P>0.05).Conclusions Clozapine,risperdal blood drug concentration in the treatment of patients with increased within the scope of the weight and blood lipid metabolism all have influence,and the influence of clozapine more than risperdal;Ziprasidone blood drug concentration in the treatment of patients with increased within the scope of the weight and blood lipid metabolic effect is not obvious.