利培酮对首发精神分裂症患者糖代谢的影响

目的:探讨利培酮对首发精神分裂症患者糖代谢的影响.方法:46例首发精神分裂症患者予利培酮治疗,于治疗前和治疗4周末测定空腹血糖(FPG)及餐后2 h血糖(2hPG)、三酰甘油、胆固醇、胰岛素、瘦素、胰岛素抗体,并测量身高、腰围、体质量,计算体质量指数(BMI),量表采用阳性与阴性症状量表(PANSS).结果:治疗第4周末与治疗前相比,2hPG、瘦素、BMI、腰围、血脂、糖耐量异常率明显增高,PANSS总分明显减低.治疗前2hPG与胆固醇、腰围均呈正相关,空腹血糖与BMI呈正相关;治疗4周末2hPG、FPG与腰围均呈正相关.患者年龄、用药剂量是糖耐量异常的有关危险因素.结论:精神分裂症患者在药物治疗的初期就应进行2hPG检测,尤其是年长者和药量较大者.

An investigation of effect of risperidone on glucose metabolism in onset patients with schizophrenia

Objective:To investigate the effect of risperidone on glucose metabolism in patients with schizophrenia.Method:46 inpatients with schizophrenia treated by risperidone before treatment and after 4 weeks treatment respectively examining fasting plasma glucose(FPG),2 hour post meal plasma glucose(2hPG),blood lipid,triglyceride,cholesterol,insulin,leptin,and insulin antibody,measuring height,waist circumference,body weight and body mass index(BMI),and using positive and negative symptom syndrome scale(PANSS)to evaluate the antipsychotics efficacy.Results:Compared with that before treatment,2hPG,leptin,BMI,waist circumference,blood lipid and the rate of abnormity of oral glucose tolerance test were significantly higher,total score of PANSS markedly lower after 4 weeks treatment.The level of 2hPG was significantly correlated with the level of triglyce ride and the width of waist circumference respectively and the level of FPG was positively related to BMI before the treatment.The level of 2hPG or FPG was significantly correlated with the width of waist circumference after 4 weeks treatment.Age and dosage taken were the related risk factors to the occurrence of abnormal oral glucose tolerance test.Conclusion:Patients with schizophrenia should monitor their 2hPG at the earlier phase of their antipsychotics treatment,especially for those senior patients and those patients taking higher dosage of antipsychotics.