帕利哌酮和利培酮对首发精神分裂症患者血脂代谢影响的研究

目的探讨帕利哌酮和利培酮对首发精神分裂症患者血脂代谢影响。方法 70例首发精神分裂症患者随机分为研究组35例和对照组35例,分别给予帕利哌酮和利培酮单药治疗8周。两组患者均在治疗前与治疗结束后测量如下指标：体质量指数（BMI）、腰围（WAIST）、血清甘油三酯（TG）、高密度脂蛋白（HDL）、空腹血糖（FPG）、OGTT后2h血糖（2hPG）,采用阳性和阴性综合征量表（PANSS）进行疗效评价。结果治疗8周末两组的PANSS总分及阳性症状分、阴性症状分较治疗前均降低（P〈0.05）。8周末研究组患者的PANSS总分及阴性症状分显著低于对照组（P〈0.05）。治疗8周末研究组患者的BMI、WAIST与治疗前比较显著升高（P〈0.05）;对照组患者的BMI、WAIST、TG与治疗前比较显著升高（P〈0.05）,HDL比治疗前显著降低（P〈0.05）。两组之间比较,研究组BMI、WAIST、TG低于对照组,HDL高于对照组（P〈0.05）。结论帕利哌酮对首发精神分裂症的疗效优于利培酮,引起代谢综合征的风险小于利培酮。

Study on lipid metabolism in first-episode schizophrenia treated with paliperidone and risperidone

Objective To explore the influence of paliperidone and risperidone on level of lipid metabolism in patients with first-episode schizophrenia. Methods 70 patients with first-episode schizophrenia were randomly divided into study group （35 eases） and control group （35 eases） treated with paliperidone and risperidone respectively for 8 weeks. Body mass index （BMI）, waist circumference （WAIST）, serum triglyceride （TG）, high-density lipoprotein （HDL）, fasting plasma glucose （ FPG）, blood glucose 2h after OGTT （2 HPG） were measured at baseline and at the end of the treatment in both gorups. All patients were assessed with Positive and Negative Syndrome Scale （PANSS） at baseline and at the end of the treatment to evaluate the efficiency. Results Total score and factor scores of positive symptoms and negative symptoms of PANSS decreased significantly at the end of the 8-week treatment in both groups when compared with the baseline （ P 〈 0.05 ）. Total score and factor score of negative symptoms of PANSS at the end of the treatment in study group were significantly lower than those in control group （P 〈 0.05 ）. At the end of the treatment, BMI and WAIST in study group, as well as BMI, WAIST and TG in control group increased significantly, while HDL in control group decreased significantly when compared with the baseline （ P 〈 0.05）. BMI, WAIST, TG in study group were significantly lower than those in control group, while HDL in study group was significantly higher than that in control group （ P 〈 0.05 ）. Conclusion Paliperidone has better efficiency and lower risk of metabolic syndrome than risperidone for treating first-episode schizophrenia.