精神分裂症患者四种抗精神病药对血脂代谢影响的差异

目的：探究4种抗精神病药对首发精神分裂症患者脂代谢影响的差异。方法：回顾性分析2000年1月~2008年1月期间入我院的首发精神分裂症患者291例,分析4种抗精神病药物治疗8周前后的胆固醇（TC）、三酰甘油（TG）浓度。结果：①氯丙嗪和氯氮平治疗后TC（P〈0.05,P〈0.05）与TG（P〈0.01,P〈0.05）均显著升高。②4种不同的抗精神病药物对TC的影响程度为氯氮平〉氯丙嗪〉利培酮和舒必利,差异均有统计学意义（P〈0.05）;4种不同的抗精神病药物对TG的影响程度为氯氮平和氯丙嗪〉利培酮和舒必利,差异均有统计学意义（P〈0.05）。③氯丙嗪组和氯氮平组男性患者TC（P〈0.01,P〈0.05）与TG（P〈0.05,P〈0.05）升高的程度显著高于女性;舒必利组女性患者TG升高的程度显著大于男性患者（P〈0.01）。结论：氯丙嗪、氯氮平对脂代谢的影响大于利培酮和舒必利,并存在性别差异。

The difference of side-effects of four psychotropic drugs on the lipid metabolism in schizophrenic patients with their first episode

Objective： To explore the side-effects of four psychotropic drugs on the lipid metabolism in schizophrenic patients with their first episode.Methods： A retrospective analysis was carried out among 291 patients who were admitted to our hospital from January 2000 to January 2008.To analysis the concentrations of TC and TG after 8 week psychotropic treatment.Results： ①TC（P〈0.05,P〈0.05） and TG（P〈0.01,P〈0.05） concentrations were significantly increased in clozapine and chlorpromazine groups.②The increased level of TC was clozapine〉 chlorpromazine〉 risperidone = sulpiride and the increased level of TG was clozapine= chlorpromazine〉 risperidone = sulpiride.③In clozapine and chlorpromazine groups,the increased levels of TC（P〈0.01,P〈0.05）and TG（P〈0.05,P〈0.05）were higher in male than those in female,however,there was opposite change in sulpiride group.Conclusion： Clozapine and chlorpromazine had the more severe side-effects on the lipid metabolism than risperidone and sulpiride with gender difference.