氯氮平和利培酮对精神分裂症患者体质量的影响

目的:探讨氯氮平和利培酮对精神分裂症患者体质量(体重)的影响及相关因素。方法:选择符合国际疾病分类第10版(ICD-10)精神分裂症的诊断标准,空腹血糖正常,无严重躯体疾病,1周内未用任何抗精神病药的住院患者,共计65例,其中利培酮组32例,氯氮平组33例。两组患者于治疗前和治疗6周末分别做葡萄糖耐量试验,测空腹血胰岛素,测量体质量、身高,计算体质量指数(BMI),评定阳性与阴性症状量表(PANSS)。结果:①治疗后体质量增加者氯氮平组24例(占72.7%),利培酮组19例(占59.4%);氯氮平组体质量平均增加2.5kg,利培酮组1.4kg;②氯氮平组体质量增加与进食量增加、胰岛素水平增加和PANSS评分减分率相关(P<0·05),体质量增加者餐后1h血糖升高;③利培酮组体质量增加与年龄、病程显著相关(P<0·05),与基础BMI存在负相关倾向;④两组治疗后均出现糖耐量减低(IGT)和暂时诊断糖尿病(DM)。结论:氯氮平和利培酮均能导致体质量增加,体质量增加更易对糖代谢造成不良影响。

Effects of clozapine and risperidone on body weight of schizophrenic patients

Objective:To detect the effect on body weight of schizophrenic patients by clozapine and risperidone and its related factors. Method:Inpatients who met the diagnostic criteria of schizophrenia in ICD-10,normal fasting blood glucose,without seriors somatic disease,and without any antipsychotic was used before 1 week were selected in this study.All of them were 65 cases:32 cases in risperidone group and 33 cases in clozapine group.Glucose tolerance test was made before the treatment and 6 weeks after the treatment in both groups of patients.Fasting insulin level,body weight,body height,body mass index (BMI) and positive and negative symptoms scale(PANSS) were examined. Results:1.Body weight increased after the treatment in clozpine group were 24 cases(72.7%)and 19 cases(59.4%)in risperidone group.Net weight was increased 2.5 kg in clozapine group and 1.4 kg in risperidone group.2.There was relationship among increasing of body weight and increasing of meal intake,increasing of insulin level and decreasing rate of PANSS (P<0.05).If patients' body weight were increased,their blood glucose leval at 1 hour after the meal were increased also. 3.Increasing of body weight were significantly related with age and the course of disorder (P<0.05).There was negative relationship with BMI.4.Glucose tolerance was decreased after the treatment and diagnosed to diabetes mellitus temporary in both groups. Conclusion:Both clozapine and risperidone can induce to increase body weight.This will make more disadventage effects on glucose metabolism.