氟西汀联合小剂量舒必利治疗抑郁症对照研究

1、氟西汀联合小剂量舒必利治疗抑郁症对照研究<    【关键词】   奥氮平；利培酮；体重；血糖；血脂【摘要】 目的  探讨奥氮平与利培酮对老年精神分裂症患者血糖、血脂的 影响 。 方法   将44例老年精神分裂症患者随机分为两组，每组各22例，分别给予利培酮和奥氮平 治疗 ，观察8 w。治疗前及治疗第8 w末检测体重指数、空腹血糖、胆固醇、甘油三酯。采用简明精神病量表评定 临床 疗效，并进行对比 分析 。 结果  利培酮组治疗前后体重指数、空腹血糖、胆固醇、甘油三酯差异均无显著性（P0.05），奥氮平组治疗后上

2、述各项水平明显升高，与治疗前比较均有显著性差异（P0.05）；两组简明精神病量表减分率与治疗前后的体重指数、空腹血糖、胆固醇、甘油三酯均无明显相关性（P0.05）。 结论  奥氮平对老年精神分裂症患者的血糖、血脂影响较利培酮显著，两组疗效与患者的体重指数、血糖、血脂变化无必然 联系 。【关键词】 奥氮平；利培酮；体重；血糖；血脂 The effects of risperidone and olanzapine on the glucose metabolism and lipid metabolism in elderly patients with schizophrenia【A

3、bstracts】 Objective  To explore the effects of risperidone and olanzapine on  the glucose metabolism and lipid metabolism in elderly patients with schizophrenia. Methods  44 elderly schizophrenic patients were divided into risperidone group(treated with risperidone) and olanzapine gro

4、up(treated with olanzapine). Before and after 8week treatment, the fasting blood glucose (FBS), cholesterol (CHOL),triglyceride (TG), h Ei ght, body w EI ght were measured. The body mass index(BMI) was calculated. And the efficacy was evaluated by brief psychiatric rating scale(BPRS).Results  (

5、1)After treatment, the levels of FBS、CHOL、TG and BMI increased significantly in olanzapine group(P0.05).(2)There were no clearly correlations between the decreasing ratio of BPRS score and the difference of BMI levels before and after treatment or the difference of FBS,CHOL, TG levels. （P0.05）.(3) T

6、he changes of BMI、FBS、CHOL、TG levels before and after treatment were not significant between efficiency group and inefficiency group whether in risperidone group or in olanzapine group （P0.05）.Conclusion  Olanzapine has more significant effects on the glucose metabolism and lipid metabolism tha

7、n risperidone does in elderly patients with schizophrenia. There were no necessary correlations between therapeutic efficacy and the changes of BMI, or FBS,CHOL, TG levels when treated with pisperidone or olanzapine.   【Keywords】 Olanzapine；risperidone；weight; blood glucose；blood lipid大量 研

8、究 1,2表明，多数传统抗精神病药和新型抗精神病药都会引起精神分裂症患者糖代谢、脂代谢的异常，导致患者出现明显的体重指数增加，并增加了患者糖尿病、高血压、冠心病的患病风险。本文比较了利培酮和奥氮平对老年精神分裂症患者糖代谢、脂代谢的影响，现 报告 如下。 1 对象与方法 1.1 对象  选取我院44例住院老年精神分裂症患者为观察对象。入组标准：（1）符合 中国 精神障碍分类与诊断标准第3版（CCMD3）精神分裂症诊断标准；（2）入组前1 mo内未服用抗精神病药；（3）年龄60 a；（4）血常规、肝肾功能、空腹血糖均在正常范围；（5）所有患者家属对本研究知情同意；（6）排除糖代谢异常及

9、其它影响糖代谢因素、高血压、严重肝肾等重大躯体疾病及药物、酒精依赖者。共入组44例，随机分为两组各22例。利培酮组男12例，女10例；年龄60 a71 a，平均(64.3±3.2) a；病程0.3 a3.0 a，平均(1.6±1.1) a。奥氮平组男11例，女11例；年龄61 a70 a，平均(63.±3.9) a；病程0.4 a3.2 a，平均(1.8±1.4) a。两组患者性别、年龄、病程差异无显著性（P均0.05）。1.2 方法 2 结果 2.1 两组治疗前后各种检测指标及BPRS总分比较，见表1。表1  两组治疗前后检测指标及BPRS总分比较（略）注：经配对t检验，与治疗前比较，*P0.01；     表1显示，两组治疗前的BMI,FBS,CHOL,TG,BPRS总分的差异均无显著性（t=1.41，0.67，0.23，0.68，0.78;P=0.17，0.51，0.82，0.51）。治疗后两组间BMI,FBS,CHOL,TG,BPRS总分比较（t=2.02，0.69，0.21，3.4