奥氮平与氯氮平治疗男性精神分裂症患者的疗效及对糖脂代谢的影响

摘要

目的：探讨奥氮平、氯氮平治疗男性精神分裂症患者的疗效及对糖脂代谢的影响。方法：70例男性精神分裂症患者随机分为奥氮平组和氯氮平组各35例治疗8周；采用阳性与阴性症状量表（PANSS）在治疗前后进行评估，同时检测血总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）及空腹血糖（FPG）水平并进行比较。结果：两组 PANSS 各项评分治疗后均显著下降（P <0.05或 P <0.001）；两组间比较差异无统计学意义（ P >0.05）。两组血 TC、TG、LDL 交互效应（F =2.932，F =4.159，F =3.911）、TC、LDL、FPG 组间主效应（F =4.595，F =4.798，F =5.856）、TC、TG、FPG 时间主效应（F =3.224，F =5.389，F =3.979）均存在统计学意义（P <0.05或 P <0.01）。结论：奥氮平与氯氮平治疗男性精神分裂症患者疗效相当；对糖脂代谢均有影响，以奥氮平影响更为明显。%Objective:To investigate the effects of olanzapine and clozapine on glucose and lipid metabo-lism in patients with schizophrenia. Method:Seventy cases of male schizophrenic patients were randomly di-vided into olanzapine group and clozapine group with 35 cases in each group for 8 weeks. To assess the efficacy with positive and negative symptom scale(PANSS)before and after treatment. Detect and compare the serum to-tal cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL)and fast-ing plasma glucose(FPG)levels. Results:PANSS scores in the two groups were significantly decreased after treatment(P < 0. 05 or P < 0. 01). There was no significant difference between the two groups(P > 0. 05). There were statistical significance on interaction effect of the two groups TC,TG,LDL(F = 2. 932,F = 4. 159, F = 3. 911;P < 0. 05 or P < 0. 01),TC,LDL,FPG group main effect(F = 4. 595,F = 4. 798,F = 5. 856;P <0. 05 or P < 0. 01)and TC,TG and FPG time effect(F = 3. 224,F = 5. 389,F = 3. 979;P < 0. 05 or P < 0. 01). Conclusion:Olanzapine and clozapine have similar curative effect in the treatment of schizophrenia,and both have effect on glucose and lipid metabolism,but the effect of olanzapine was more obvious.