摘要
目的比较不同抗精神病药物对精神分裂症患者的血糖、血脂及甲状腺素的影响,提高药物使用安全性,指导临床规范应用。方法 120例精神分裂症患者,随机分为三组,按使用抗精神病药物的差异分为Ⅰ利培酮组,Ⅱ氯氮平组,Ⅲ阿立哌唑组,每组各40例,各组患者给予相应的抗精神病药物治疗,每组患者均观察6个月,比较治疗前后空腹血糖、甘油三酯、总胆固醇、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)的变化情况。结果 (1)氯氮平组治疗后空腹血糖、甘油三酯、总胆固醇均显著升高,但利培酮组、阿立哌唑组治疗后空腹血糖、甘油三酯、总胆固醇升高不明显。另一方面,治疗后氯氮平组患者空腹血糖、甘油三酯、总胆固醇显著高于利培酮组、阿立哌唑组,差异具有统计学意义;(2)治疗后利培酮组、氯氮平组三碘甲状腺原氨酸、甲状腺素、促甲状腺素明显改变,阿立哌唑组没有明显改变。另一方面,治疗后阿立哌唑组游离甲状腺素(FT4)、甲状腺素(T4)明显高于利培酮组和氯氮平组,且三碘甲状腺原氨酸(T3)高于氯氮平组,促甲状腺素(TSH)低于氯氮平组。结论抗精神病药可导致精神分裂症患者血糖、血脂、甲状腺素的变化,且不同药物影响程度各有差异,影响程度大小分别为氯氮平、利培酮、阿立哌唑,应加强对患者用药后的血糖、血脂及甲状腺素监测,为抗精神病药物合理选择及调整用药提供依据,以利于精神分裂症患者全程治疗的有效性和安全性。
Objective To explore the effect of different antipsychotics on hyperglycemia,hyperlipidemia and thyroxine of patients with schizophrenia,and improve the safety of drug use and direct its standard application clinically.Methods Analyze the clinical data of 120 schizophrenics.They were randomly divided into three groups,defined by the diversity of taking antipsychotics,with 40 in each group.Group I was risperidone group,group Ⅱ was clozapine group,group Ⅲ was aripiprazole group.Each group was treated by corresponding antipsychotic drug and observed for 6 months.Compared the changes of fasting blood sugar,triglyceride,totalcholesterol,freetriiodothyronine（FT3）,freethyroxine（FT4） and thyrotropin（TSH） before and after treatment.Results（1） After treatment,fastingbloodsugar,triglyceride and totalcholesterol significantly increase in clozapine group,not in risperidone group and aripiprazole group.In the other hand,fasting blood sugar,triglyceride and totalcholesterol in clozapine group were significantly higher than in risperidone group and aripiprazole group.The difference was statistically significant.（2） After treatment,freetriiodothyronine（FT3）,thyroxine and thyrotropin（TSH） in risperidone group and clozapine group were significant change,not in aripiprazole group.In the other hand,freethyroxine（FT4） and thyroxine（T4） in ripiprazole group were significantly higher than in risperidone group and clozapine group.Furthermore,triodothyronine（T3） in aripiprazole group was higher than clozapine group,thyrotropin（TSH） in aripiprazole group was lower than clozapine group.Conclusions Antipsychotics can induce the change of blood sugar,blood lipid and thyroxine,different influence degree in different drug was different.The sequence of affecting was clozapine group,risperidone group and aripiprazole group.We must strengthen the blood sugar,blood lipid and thyroxine in patients after treatment,to provide basis for rational selection and use of antipsychotics,it will be beneficial to
出处
《齐齐哈尔医学院学报》
2013年第14期2031-2033,共3页
Journal of Qiqihar Medical University
