徐学文　　吴向平　　马宏　　翁金丽　　胡长舟

[摘要] 目的 探讨3种抗精神病药物对精神分裂症患者血糖指标、血脂指标的影响。 方法 选取2018年1月至2019年12月我院收治的精神分裂症患者共120例进行分组研究，根据使用药物的不同分为奥氮平组（A组）、利培酮组（B组）和阿立哌唑口崩片组（C组），每组各40例，分别口服对应药物治疗，治疗周期1个月。于治疗前后分别检测入组患者的空腹血糖、餐后2 h血糖、总胆固醇和三酰甘油并统计分析。 结果 治疗前后B、C两组各项指标检测结果相比较，差异均无统计学意义（P>0.05）;治疗后A组空腹血糖（FBG）、餐后2 h血糖（2 hPBG）、三酰甘油（TG）指标检测结果均较治疗前显著升高，且显著高于治疗后的B、C两组，差异有统计学意义（P<0.05）。 结论 抗精神病药物用于精神分裂症患者的治疗时，利培酮和阿立哌唑口崩片对糖脂代谢影响较小，奥氮平可显著升高血糖、血脂水平，临床应用中应引起重视。

[关键词] 精神分裂症;抗精神病药物;血糖;血脂

[中图分类号] R749.3          [文献标识码] B          [文章编号] 1673-9701（2021）11-0104-04

Analysis on the impacts of three antipsychotics on the indexes of blood glucose and blood lipid in schizophrenic patients

XU Xuewen   WU Xiangping   MA Hong   WENG Jinli   HU Changzhou

Department of Psychiatry， Ningbo Kangning Hospital， Ningbo   315000， China

[Abstract] Objective To investigate the impacts of three antipsychotics on the indexes of blood glucose and blood lipid in schizophrenic patients. Methods A total of 120 schizophrenic patients admitted to our hospital from January 2018 to December 2019 were selected and divided into the olanzapine group（group A， n=40）， the risperidone group （group B， n=40） and the aripiprazole orally disintegrating tablets group （group C， n=40） according to the different drugs used. Corresponding drugs were administrated orally to patients for one month. Before and after treatment， fasting blood glucose （FBG）， 2-hour postprandial blood glucose（2 h PBG）， total cholesterol and triglyceride （TG） levels were detected and statistically analyzed. Results There was no statistically significant difference in test results of various indexes between group B and group C before and after treatment （P>0.05）. After treatment， all indexes detection results of FBG， 2 hPBG and TG in group A were raised more significantly than those before treatment， which were higher than those in the group B and group C after treatment， with significant difference（P<0.05）. Conclusion When antipsychotic drugs are applied in the treatment of schizophrenia， the risperidone and aripiprazole orally disintegrating tablets have little impact on glucose and lipid metabolisms， while olanzapine can significantly raise blood glucose and blood lipid levels， which should be paid attention to in clinical application.

[Key words] Schizophrenia; Antipsychotic drugs; Blood glucose; Blood lipid

精神分裂症是一组常见且病因未明的慢性和致残性精神疾病，以感知觉、思维、情感、行为等多方面障碍及精神活动的不协调为特征，病程多迁延，对个人、家庭乃至整个社会都有重大影响[1-3]。精神分裂症患者主要自青少年期或成年早期起病，其典型表現为反复出现的阳性症状（如精神功能的异常或亢进、明显的思维障碍以及反复的行为紊乱和失控等）和阴性症状（如精神功能减退或缺失、情感平淡以及注意障碍等）[4-5]。最新流行病学调查显示，全球范围内精神分裂症的年龄标准化发病率为0.28%，最近国内学者发现，我国精神分裂症及其他精神病性障碍终生患病率为0.75%，30 d患病率为0.61%[6]。在精……