氯氮平和利培酮对精神分裂症病人体重、瘦素及脂代谢的影响

目的 :观察氯氮平、利培酮对精神分裂症病人体重、瘦素及脂代谢的影响。方法 :6 4例 1mo内未服药的精神分裂症病人分入氯氮平 (n =33)或利培酮组 (n =31)治疗 8wk ,治疗前后测量其身高、体重、腰围、血脂水平及血清瘦素浓度 ,计算其体重指数 (BMI) ,同时评定简明精神症状评定量表(BPRS)。结果 :(1)治疗 8wk后 2组病人体重、腰围及BMI均明显增加 (P <0 .0 5 ) ;体重增加与治疗前体重、治疗前腰围及BPRS减分率无相关 (P >0 .0 5 )。 (2 ) 2组病人均有血三酰甘油 (TG)、总胆固醇 (TC)的升高 (P <0 .0 5 ) ,TG与腰围相关。 (3) 2组病人血清瘦素浓度均升高 ,瘦素浓度与性别及腰围相关。结论 :氯氮平及利培酮均能引起病人体重增加 ,同时引起血清瘦素及血脂的改变。有必要对服用氯氮平或利培酮病人的体重及脂代谢指标进行监测。

Influence of clozapine and risperidone on body weight,leptin level and lipid me tabolism in schizophrenic patients

AIM: To observe the influence of clozapine or risperidone on body weight, leptin and lipid metabolism in schizophrenic patients. METHODS: Sixty-four schizophrenics who were free of antipsychotics at least 1 mo were enrolled in clozapine group or risperidone group. They were treated either with clozapine or with risperidone for 8 wk. Height, body weight, waist-circumferences were measured before and after 8 wk treatment. Fasting blood samples for triglyceride (TG), total cholesterol (TC) and leptin were analyzed before and after treatment. Body mass index was calculated and brief psychiatric rating scales(BPRS) were evaluated at the same time. RESULTS: (1) After 8 wk treatment, patients in both groups gained weight and waist-circumferences significantly(P<0.05); (2) TG and TC were also increased in both groups(P<0.05). TG had positive correration with waist-circumferences; (3) Leptin level increased in both groups and it was associated with gender and waist-circumferences. CONCLUSION: Both clozapine and risperidone can increase body weight, serum leptin and serum TG level. It is essential to regularly monitor schizophrenic patients' weight and those indexes about lipids metabolism.