精神分裂症患者四种抗精神病药对血脂代谢影响的差异(1)
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[摘要] 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。② 4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。
[关键词] 抗精神病药；血脂；差异
[中图分类号] R749.3[文献标识码]A[文章编号]1673-7210(2011)08(a)-020-03
The difference of side-effects of four psychotropic drugs on the lipid metabolism in schizophrenic patients with their first episode
SHI Xiaoping1, ZHUANG Kailing1, ZHANG Qirong1, YI Zhenghui2, CHEN Jun2, WANG Zucheng2 , SU Yousong2*
1.Jinshan District, Shanghai Mental Health Center, Shanghai 201512,China; 2.Shanghai Jiaotong University Mental Health Center, Shanghai 200030,China
[Abstract] 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.
[Key words] Psychotropic drugs; Lipid; Difference
精神分裂症是一种严重的精神疾病，普通人群中的终生患病率大约是1%[1]，是导致精神残疾的主要病因。绝大多数患者需要长期服药，有些甚至需要长期住院治疗，给个人、家庭和社会带来了极大的负担[2]。其中药物的毒副反应是影响患者依从性的重要原因 ......
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