精神分裂症_氯氮平_氟哌啶醇_糖代谢_脂代谢_体重_

氯氮平和氟哌啶醇对慢性精神分裂症患者糖、脂代谢及体重变化的比较分析

http://www.100md.com 《四川精神卫生》 2006年第4期

精神分裂症,氯氮平,氟哌啶醇,糖代谢,脂代谢,体重,,精神分裂症,氯氮平,氟哌啶醇,糖代谢,脂代谢,体重,1对象和方法,2结果

     【摘要】目的比较氯氮平和氟哌啶醇对慢性精神分裂症患者的血糖、血脂代谢及体重变化情况。方法采用氯氮平(89例)和氟哌啶醇(87例)对慢性精神分裂症患者进行治疗，并于治疗前后不同时段作血糖、胰岛素、血脂和体重的测定，同时比较其浓度变化和进行相关性分析。结果 ①氯氮平组在用药的第3和第6个月末，血糖浓度异常发生率分别为79%及236%，氟哌啶醇组为11%和23%。②氯氮平组在用药第3个月末，空腹及餐后2小时血糖浓度均较基线值升高，第6个月末继续升高；而在氟哌啶醇组上述两个治疗时段的变化则不明显。③氯氮平组在用药的第3个月末，体重平均增高为治疗前的55%，第6个月末增高为治疗前的91%，而氟哌啶醇组则变化不明显，④两组患者在用药第6个月末，胰岛素浓度均高于基线值；氯氮平组的胆固醇和甘油三酯浓度均高于基线值，而氟哌啶醇组则无明显变化。⑤在用药第6个月时，氯氮平组血糖、胰岛素、血脂浓度、体重变化和血药浓度之间均有一定相关性(r=021~099)，差异均有统计学意义(P<005或<001)。结论氯氮平对慢性精神分裂症患者的糖、脂代谢和体重有影响，治疗期间需监测。

    【关键词】精神分裂症氯氮平氟哌啶醇糖代谢脂代谢体重

    A comparison of weight,lipid and glucose changes between clozapine and haloperidol treated chronic patients with schizophrenia.ZHANG Liang,HUANG Yuanguang,ZHANG Yongyi,et al.The Fourth Section of Clinical Psychiatry,Guangzhou Psychiatric Hospital,Guangzhou 510370,China

    【Abstract】Objective To compare the weight,lipid and glucose changes between clozapine and haloperidol treated chronic patients with schizophrenia,and correlation analysis was conducted.Method 89 patients treated with clozapine and 87 with haloperidol were recruitde weight,blood glucose,insulin,cholesterol and triglyceride were determined in baseline,third months and sixth months of treatment.Results The incidence of abnormal blood glucose after third months and sixth months of clozpaine treatment were 79% and 236% respectively.In halperidol group the incidence were 11% and 23% for third months and sixth months of treatment.Compared with baseline,the level of blood glucose of fast and 2 hours after meal in clozapine were elevated as compared with the baseline afeter third months of treatment and kept on increasing after sixth months of treatment.Little change was observed in haloperidol group at the two treatment interval.The level of blood glucose in clozapine group was higher than other group.After third months treatment,the weight increased 55% in clozapine group.After sixth months the weight increased 91% in clozapine group.No obvious change was observed in haloperidol group.The level of insulin in two groups was higher than that of the baseline after 6 months of treatment.The level of blood cholesterol and triglyceride were higher than that of the baseline after 6 months of treatment in clozapine group after 6 months of treatment.No obvious change was observed in haloperidol group.There were some correlations in the change of blood glucose,insulin,cholesterol,triglyceride and body weight.In clozapine group,the change was correlated with the level of blood clozapine(r=021~099),and there was significant difference(P<005 or P<001).Conclusion Clozapine have an impact on the metabolism of glucose and fat,as well as body weight in patients with chronic schizophrenia,therefore proper monitoring are repuired during the treatment. ......

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