首发精神分裂症患者血糖和血脂代谢情况及奥氮平治疗的影响

目的 探讨首发精神分裂症患者血糖、血脂代谢情况及奥氮平治疗对血糖、血脂代谢的影响作用。 方法 选择2014年7月—2015年12月温州市第七人民医院精神科精神分裂症患者112例作为精神分裂症组，112例健康者作为对照组。精神分裂症患者给予奥氮平治疗，治疗剂量为10～20 mg/d，共3个月。观察精神分裂症组和对照组血糖和血脂情况，观察奥氮平治疗对精神分裂症患者血糖水平、血脂水平、腹围和BMI的影响。 结果 精神分裂症组总胆固醇、高密度脂蛋白低于对照组(P＜0.05)，精神分裂症组空腹血糖、总胆固醇、甘油三酯及低密度脂蛋白和对照组比较差异无统计学意义(P＞0.05)。奥氮平治疗前、治疗后1～3个月首发性精神分裂症患者的空腹血糖水平比较差异无统计学意义(P＞0.05)。精神分裂症患者奥氮平治疗1～3个月时总胆固醇、甘油三酯和低密度脂蛋白水平明显高于治疗前(P＜0.05)。奥氮平治疗3个月时精神分裂症患者的腹围和BMI均明显高于治疗前(P＜0.05)。 结论 首发精神分裂症患者存在血脂代谢异常，奥氮平治疗影响精神分裂症患者的血脂代谢，引起患者腹围和BMI变化，对血糖代谢的影响不大。 

Blood glucose and blood lipid metabolism in first-episode schizophrenia patients and effect of Olanzapine

Objective To explore the blood glucose and lipid metabolism of episode schizophrenia patients and the influence of Olanzapine on blood glucose and lipid metabolism. Methods From July,2014 to December,2015,112 patients with schizophrenia were selected as schizophrenia group,while 112 cases of healthy subjects were recruited as control group.Schizophrenia patients were given Olanzapine with a dose of 10-20 mg/d for three months.The blood glucose and lipids metabolism of both groups were observed.The effect of Olanzapine on blood glucose levels,lipid levels,abdominal circumference and BMI in patients with schizophrenia was assessed. Results Total cholesterol and High-density lipoprotein of the schizophrenia group was lower than that of the control group(P<0.05),the difference of fasting glucose,total cholesterol,triglycerides and low-density lipoprotein between the two group were not statistically significant(P>0.05).The difference of fasting blood glucose level of before olanzapine treatment,olanzapine treatment 1 month,2 months,3 months in episode schizophrenia patients was not statistically significant(P>0.05).The total cholesterol,triglycerides and LDL levels at olanzapine treatment 1 month,2 months,3 months were significantly higher than that of before treatment(P<0.05).The abdominal circumference and BMI at olanzapine treatment 3 months in patients with schizophrenia were significantly higher than that before treatment(P<0.05). Conclusion During the episode of schizophrenia,the patients has abnormal lipid metabolism.Olanzapine therapy can improve lipid metabolism and cause the changes of abdominal circumference and BMI of patients,but has little effect on glucose metabolism.