奥氮平联合阿立哌唑对首发精神分裂症女性患者血糖及血脂水平的影响

摘要

目的 探讨奥氮平联合阿立哌唑对首发精神分裂症女性患者血糖及血脂水平的影响.方法 选取2015年5月至2017月1月新疆生产建设兵团第三师医院收治的精神分裂症女性患者156例,完全随机分为对照组(75例,单一使用奥氮平片)和联合干预组(81例,奥氮平片联合小剂量阿立哌唑口腔崩解片).在药物治疗前及治疗3个月后,分别测定患者的空腹血糖、餐后2h血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、体重指数、腰围及臀围.观察治疗过程中的不良反应发生情况.结果 对照组治疗后餐后2h血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平较治疗前明显增加;联合干预组治疗后空腹血糖、总胆固醇、三酰甘油水平较治疗前明显降低,差异均有统计学意义(均P＜0.05).治疗后联合干预组空腹血糖、餐后2h血糖、总胆固醇、三酰甘油水平明显低于对照组[(4.50±0.42) mmol/L比(4.90±0.32) mmol/L、(5.30±0.31) mmol/L比(5.90±0.21) mmol/L、(3.80±0.32) mmol/L比(4.40±0.41) mmol/L、(1.10±0.21) mmol/L比(1.40±0.12) mmol/L],差异均有统计学意义(均P＜0.05).治疗后联合干预组体重指数、腰围、臀围明显低于对照组[(22.3±0.3)kg/m2比(26.3±0.5)kg/m2、(88±11)cm比(92±11)cm、(129±10)cm比(136±8)cm],差异均有统计学意义(均P ＜0.05).联合干预组嗜睡、乏力、呕吐、心动过速等不良反应发生率均明显低于对照组(均P＜0.05).结论 奥氮平联合阿立哌唑治疗女性首发精神分裂症效果较好,能使患者的血糖及血脂维持在较理想水平,体质量增加等不良反应减少,临床治疗的安全性较好.%Objective To investigate the effect of olanzapine combined with aripiprazole on blood lipid and glucose levels in female patients with first-episode schizophrenia.Methods Totally 156 female patients with first-episode schizophrenia were enrolled from May 2015 to January 2017 in Xinjiang Production and Construction Corps Third Division Hospital;they were randomly divided into control group(n =75,treated with olanzapine) and observation group (n =81,treated with olanzapine and aripiprazole).Fasting blood glucose,postprandial 2 h blood glucose,total cholesterol,triacylglycerol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,body mass index,waistline and hipline were analyzed before and 3 months after treatment.Adverse reactions were observed during treatment.Results Levels of postprandial 2 h blood glucose,total cholesterol,triacylglycerol and low-density lipoprotein cholesterol after treatment significantly increased compared to those before treatment in control group (P ＜ 0.05).Levels of fasting blood glucose,total cholesterol and triacylglycerol after treatment significantly decreased compared to those before treatment in observation group(P ＜ 0.05).Levels of fasting blood glucose,postprandial 2 h blood glucose,total cholesterol and triacylglycerol in observation group after treatment were significantly lower than those in control group[(4.50 ± 0.42) mmol/L vs (4.90 ± 0.32) mmol/L,(5.30 ±0.31)mmol/L vs (5.90 ±0.21) mmol/L,(3.80 ± 0.32) mmol/L vs (4.40 ±0.41) mmol/L,(1.10 ±0.21) mmol/L vs (1.40 ± 0.12) mmol/L] (P ＜ 0.05).Body mass index,waisdine and hipline in observation group after treatment were significantly less than those in control group [(22.3 ± 0.3)kg/m2 vs (26.3 ± 0.5)kg/m2,(88 ± 11) cm vs (92 ± 11) cm,(129 ± 10) cm vs (136 ± 8) cm] (P ＜ 0.05).Incidences of drowsiness,fatigue,vomit and tachycardia in observation group were significantly lower than those in control group (P ＜ 0.05).Conclusion Olanzapine combined with aripiprazole treating first-episode schizophrenia has optimistic effects on blood glucose,blood lipid and body weight control in female patients.