奥氮平替换利培酮对催乳素及糖脂代谢的影响

目的探讨用奥氮平替换利培酮治疗精神分裂症后，催乳素水平及糖脂代谢的变化。方法对52例服用利培酮治疗的精神分裂症患者换为奥氮平治疗8周。于基线及换药后第8周测空腹催乳素、胰岛素、血糖、甘油三酯、胆固醇、脂蛋白及体重。结果换用奥氮平8周后，催乳素水平显著下降，胰岛素、甘油三酯、栽脂蛋白A1、载脂蛋白B水平均显著升高，体重显著增加（均P〈0．05）。总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平略有升高，空腹血糖略有下降，但差异均无统计学意义（均P〉0．05）。结论奥氮平替换治疗能够明显的改善利培酮所致的高催乳素血症，但也可能会引起脂代谢异常。

The effects of olanzapine switched from risperidone on prolactin, glucose and lipid metabolism

Objective To explore effects of olanzapine switched from risperidone on prolactin, glucose and lipid metabolism in schizophrenic patients. Methods 52 schizophrenic patients were recruited to take part in an 8--week, open--label trial of olanzapine （10--30mg/day） as a replacement for risperidone. At baseline and the end of weeks 8, prolactin （PRL）, the fasting blood glucose （FBS）, insulin （INS）, cholesterol （CHO）, triglyceride （TG）, highdensitylipoprotein--cholesterol （HDL）, lowdensi- tylipoprotein--cholesterol （LDL）, apolipoprotein A1 （APOA1）, apolipoprotein B （APOB） and body weight were measured. Results 8 weeks after replacement, compared to baseline, PRL levels were reduced significantly. The levels of INS, TG, APOA1, APOB and body weight, however, were increased significantly （P 〈 0.05）. Although the levels of CHO, HDL and LDL were elevated and FBS level was declined, no significant difference was found between baseline and 8--week treatment （P 〉 0.05）. Conclusions Switching from risperidone to olanzapine may be useful for resolving risperidone--induced hyperprolactinemia, but may induce the metabolic disorder of blood glucose and lipid.