二甲双胍防治奥氮平所致糖代谢异常的研究

目的：观察精神分裂症患者服用奥氮平后体重指数（BMI）和血糖变化，以及二甲双胍防治奥氮平所致糖代谢异常的作用。方法选择83例初次确诊精神分裂症患者，分为奥氮平单独治疗组（对照组42例）和二甲双胍联合奥氮平治疗组（联合治疗组41例），观察治疗前后两组BMI、空腹血糖和餐后2 h血糖水平变化。结果联合治疗组BMI、餐后2 h血糖治疗前后差异有统计学意义（t分别=40.50、4.95，P均＜0.05）；空腹血糖治疗前后差异无统计学意义（t=0.24，P＞0.05）。对照组BMI、空腹血糖、餐后2 h血糖治疗前后差异有统计学意义（t分别=59.85、10.23、10.13，P均＜0.05）；治疗后两组患者BMI间差异无统计学意义（t=0.01，P＞0.05），平均空腹血糖和平均餐后2 h血糖差异有统计学意义（t分别=4.51、8.77，P均＜0.05）。治疗期间对照组患者的糖尿病发生率明显高于联合治疗组，差异有统计学意义（χ2=2.51，P＜0.05）。结论奥氮平可以增加精神分裂症患者BMI、空腹和餐后血糖，增加患糖尿病的风险，合并使用二甲双胍可以降低奥氮平导致的空腹以及餐后血糖升高和罹患糖尿病的风险。

Prevention effect of metiformin for impaired glucose metabolism caused by olanzapine

Objective To observe body mass index and blood sugar changes before and after taking olanzapine, and the prevention effect of metiformin for impaired glucose metabolism caused by olanzapine. Methods Totally 83 schizophrenic were enrolled, divided to olanzapine group（O group,42 cases） and metformin joint olanzapine group（M＋O group, 41 cases）. BMI, fasting blood-glucose and postprandial blood sugar changes before and after treatment were observed. Results After 6 month treatments, BMI and postprandial blood sugar had statistic differences in M＋O group compared with those before treatment（t=40.50,4.95,P〈0.05）; fasting blood-glucose had no statistic differences（t=0.24,P〉0.05）. After treatments, BMI, fasting blood-glucose, and postprandial blood sugar had statistic differences in O group compared with those before treatment （t=59.85,10.23,10.13,P〈0.05）;No significant statistic difference were found in BMI between the two groups after treatment （t=0.01,P〉0.05）;there were significant differences in fasting blood-glucose and postprandial blood sugar between the two groups after treatment（t=4.51,8.77,P〈0.05）. The incidence of diabetes had statistic difference between the two groups （χ^2=2.51,P〈0.05）. Conclusions The BMI, fasting blood-glucose, postprandial blood sugar and risk of diabetes were increased after olanzapine treatment; coadministration metiformin is helpful to control the fasting blood-glucose, postprandial blood sugar and risk of diabetes caused by olanzapine.