二甲双胍对抗精神病药所致精神分裂症患者肥胖及糖脂代谢的影响

摘要

目的：观察二甲双胍对抗精神病药所致精神分裂症患者肥胖及糖脂代谢的影响。方法：122例长期服用抗精神病药所致肥胖的精神分裂症患者随机分为研究组62例和对照组60例，两组维持原有抗精神病药治疗不变，研究组加用二甲双胍1•0 g∕d，疗程6个月。两组分别于基线及治疗后1、3、6个月测定空腹血糖（ FBG ）、餐后2 h血糖（2 hPBG ）、总胆固醇（ TC ）、三酰甘油（ TG ）、低密度脂蛋白（ LDL）、高密度脂蛋白（ HDL）及体质量指数（ BMI）。结果：在治疗后1~3个月，研究组FBG、2 hPBG、TC、TG、LDL、HDL及BMI各项指标均逐步下降，并低于对照组（ t＝2•03~2•35，P均＜0•05）；治疗6个月，研究组除HDL外，LDL、BMI、FBG、2 hPBG、TC、TG均明显低于对照组（ t＝2•08~4•47，P＜0•05或P＜0•01）。结论：二甲双胍可降低抗精神病药所致肥胖者的血糖、血脂水平及体质量。%Objective:To investigate the effects of metformin on obesity,glucose and lipid metabolism caused by antipsychotic drugs in schizophrenia patients• Method:122 schizophrenia patients with obesity who have received long_term antipsychotic treatment were randomly divided into research group( 62 ) and control group(60)•Both groups maintain the original antipsychotic drugs and the research group were combined with metformin 1•0 g∕day for 6 months•The fasting blood_glucose(FBG),2 hour postprandial blood glucose(2 hP_BG),total cholesterol( TC),triglyceride( TG),low density lipoprotein( LDL),high density lipoprotein (HDL)and the body mass index(BMI)were measured at the baseline and at the end of 1st,3rd,6th month•Results:At the end of 1 and 3 months after treatment,all the observed indicators in the research group descen_ded with the time and were lower than those in the control group(t=2•03_2•35,P<0•05);at the end of 6 month,the levels of LDL,BMI,FBG,2 hPBG,TC and TG in research group were significantly lower than those in control group(t=2•08_4•47,P<0•05 or P<0•01),except for HDL• Conclusion:Metformin could down_regulate the blood glucose,blood lipid level and BMI caused by antipsychotic drugs in schizophrenia patients.