抗精神病药对血脂影响的临床分析

目的比较抗精神病药对精神分裂症患者血脂的影响，评价药物的安全性。方法选择260例精神分裂症患者，临床分为奥氮平组（61例），喹硫平组（65例），利培酮组（72例），阿立哌唑组（62例），药物治疗8周前后TC（胆固醇）、TG（甘油三脂）、HDLC（高密度脂蛋白）、LOLC（低密度脂蛋白）、载脂蛋白A、载脂蛋白B。结果阿立哌唑对血脂影响较小，差异无统计学意义（P〉0．05）。其他三种抗精神病药物可引起血脂TC、TG、LOL．C、apoB升高，其中TC、TG升高明显，其升高程度由强到弱依次为：奥氮平〉喹硫平〉利培酮，差异均有统计学意义（P〈0．05或P〈0．01）；可引起血脂HDL水平降低，其降低程度由强到弱依次为：奥氮平〉喹硫平〉利培酮，差异均有统计学意义（P〈0．05）。结论四种抗精神病药物中阿立哌唑对血脂影响较小，奥氮平、喹硫平、利培酮皆引起血脂异常，在治疗精神分裂症时应采取相应的干预措施。

To Study The Side-effects of Antipsychotic Drugs on The Blood Lipid

Objective To study the side-effects of antipsychotie drugs on the blood lipid in sehizophrenic patients. Methods 260 schizophrenic patients were divided into olanzapine group（ n = 61 ）. Quetipine group（ n = 65 ）. Risperidone group （ n = 72 ） and aripiprazole group （ n = 62 ）. Before and after eighe-weeks treatment, the TC, TG, HDL. C, LOL. C, apoA, apoB were measured. Results After treatment, the TC. TG. LOL. C and apoB levels increased in the other groups except in aripiprazole group, especially the TC and TG level. The increase level was olanzapine 〉 Quetipine 〉 risperidone （P 〈 0. 05 或 P 〈 0. 01 ） . And the HDL level was decreased . The decreased level was olanzapine 〉 Quetipine 〉 risperidone （ P 〈 0. 05 ）. Conclusion In the four antipsychotic drugs, aripiprazole have less side-effeces on lipid metabolism than the other drugs.