非典型抗精神病药物治疗精神分裂症所致代谢综合征对照研究

目的探讨非典型抗精神病药物治疗精神神分裂症患者导致代谢综合征的发生状况。方法将同期住院的128例精神分裂症患者随机分为A组、B组、C组、D组，每组32例，分别口服氯氮平、奥氮平、喹硫平、阿立哌唑治疗，观察12周。于治疗前及治疗4周、8周、12周末测量身高、体质量及腰围，计算体质量指数，检测血糖、血脂、胰岛素等。结果4组患者治疗12周末均出现不同程度的代谢异常，A组代谢综合征发生率为37．5％、B组为28．12％、C组为34．37％，D组为3．12％，以A组、B组、C组尤为明显（P〈0．05或0．01）。治疗8周末起，A组、B组、C组体质量、体质量指数、腰围、空腹血糖、胰岛素、胰岛素抵抗指数各项指标检测结果均较治疗前显著升高（P〈0．05或0．01），D组各项指标与治疗前比较差异均无显著性（P〉0．05）。结论不同类型的非典型抗精神病药物导致代谢综合征的发生率有较大差异性，以氯氮平、喹硫平、奥氮平治疗导致代谢综合征的发生更为显著。

A control study of metabolic syndrome induced by atypical antipsychotics in schizophrenia

Objective To explore the development status of metabolic syndrome induced by atypical antip- sychotics in schizophrenia. Methods A total of 128 contemporaneously hospitalized schizophrenics were randomly assigned to group A, B, C and D of 32 patients each, they respectively took orally clozapine, olanzapine, quetiapine or aripiprazole for 12 weeks. Body height, body mass and waist circumference were measured at baseline and at the end of the 4th, 8th and 12th week, body mass indexes （BMI） computed, blood glucose, blood lipid, insulin etc. detected. Results At the end of the 12th week patients of all 4 groups showed different degrees of metabolic disorder, incidence of metabolic syndrome was 37. 5% in group A, 28.12% B, 34.37% C and 3.12% D, and metabolic syndrome in group A, B and C was more obvious （P〈0.05 or 0.01）. Since the end of the 8th week body mass, BMI, waist circumference, blood- fasting sugar, insulin and insulin resistance index increased more significantly compared with pretreatment in group A, B and C （P〈0.05 or 0.01）, there were no significant differences in each index between post- and pre-treatment in D （P〉0.05）. Conclusion Incidences of metabolic syndrome induced by different types of atypical antipsychotics have larger difference, metabolic syndrome induced by clozapine, quetiapine or olanzapine is more significant.