摘要
目的:通过随访了解长期住院服用氯氮平的精神分裂症患者8年前后糖代谢的变化情况。方法:自制一般情况调查表,针对8年前调查过的92例长期收住我院的服用氯氮平的男性精神分裂症患者,回顾糖尿病病史,检测空腹血糖、餐后2小时血糖、血脂,计算体重指数。结果:随访到68例患者,糖尿病者15例(22.1%),糖代谢异常者34例(50%),与8年前相比,糖代谢异常发生率、糖尿病发生率均有明显增加;空腹血糖、餐后2小时血糖、甘油三酯、胆固醇无明显变化,体重指数明显减低。氯氮平高、低剂量组间除了年龄、病程有显著性差异外,胆固醇、甘油三酯、空腹血糖、餐后2小时血糖、体重指数、糖代谢异常发生率及糖尿病发生率均无显著性差异。脱落24例,其中13例死亡。脱落病例与未脱落病例的随访前相比糖尿病发生率、糖代谢异常发生率无显著差异,而死亡病例与未脱落病例的随访前相比糖代谢异常发生率增高明显。结论:长期服用氯氮平的精神分裂症患者糖尿病发生率高于普通人群,糖代谢紊乱明显,临床上早期积极干预尤为重要。
Objective：To study the changes of schizophrenic inpatients who took Clozapine in glucose metabolic condition in eight years by follow - up. Methods： Diabetes mellitus histories in 92 chronic schizophrenic inpatients who took Clozapine investigated eight years ago were reviewed. Fasting venous plasma glucose （FVPG） and 2h postprandial plasma glucose （2hPG） and blood lipids were tested and BMI was calculated. According to the blood glucose level of fasting plasma and 2 hours plasma, we diagnosed diabetes mellitus （DM）, impaired fasting glucose （IFG） and impaired glucose tolerance （IGT） which are associated with diabetes mellitus. Results： 68 cases were investigated. 15 cases （22.1%） were diabetes mellitus and 34 cases （50%） were glucose metabolic abnor- mality. Compared with eight years ago, both the incidences of diabetes mellitus and the incidences of glucose metabolic abnormality were significantly increased, FVPG , 2hPG, triglyceride and cholesterol had no significant change and BMI were significantly de- creased. There were 24 shedding cases. Among them, there were 13 death cases. Compared shedding cases and no shedding cases eight years ago, there was no significant difference in the incidences of diabetes mellitus and the incidences of glucose metabolic abnor- mality. However the incidences of glucose metabolic abnormality of death cases eight years ago were significantly higher than that of no shedding cases eight years ago. Conclusions ： The prevalence of diabetes mellitus in chronic schizophrenics who took Clozapine in hos- pital long - term is higher than that in the general population. Glucose metabolism is markedly disorder. In clinic active intervention early is especially important.
出处
《中国民康医学》
2012年第23期2835-2837,共3页
Medical Journal of Chinese People’s Health
关键词
氯氮平
精神分裂症
糖尿病
糖代谢异常
随访
Clozapine
Schizophrenia
Diabetes mellitus
Glucose metabolic abnormality
Follow - up
