奥氮平联用齐拉西酮对老年精神分裂症患者糖脂代谢血清瘦素及催乳素水平的影响

摘要

目的：探讨奥氮平联合齐拉西酮对老年精神分裂症患者的糖脂代谢、血清瘦素及催乳素水平的影响。方法共纳入86例老年精神分裂症患者，采用随机数字法平均分为两组，A组给予奥氮平联用齐拉西酮治疗；B组单独给予奥氮平治疗。所有患者均测量治疗前、治疗后的PANSS评分、空腹血糖、糖化血红蛋白（HbA1c）、三酰甘油（TG）、胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、体质量、血清瘦素及催乳素水平。结果治疗前后PANSS量表分值对比显示两组患者治疗后1、6周PANSS评分显著低于治疗前，差异有统计学意义（P＜0．05）；但治疗后两组患者PANSS量表分值比较差异无统计学意义（P＞0．05）。两组患者治疗前后比较：A组患者空腹血糖、HbA1c、TG、TC、HDL-C、LDL-C和体质量治疗前、后比较差异无统计学意义（P＞0．05）；B组患者空腹血糖、HbA1c、TG、TC、HDL-C、LDL-C和体质量治疗前后比较差异有统计学意义（P＜0．05）。两组患者治疗后空腹血糖、TC、LDL-C和体质量比较，差异有统计学意义（P＜0．05）；与B组患者相比，A组患者的空腹血糖、TC、LDL-C和体质量明显较低。两组患者治疗前后瘦素、催乳素对比显示：与治疗前相比，两组患者治疗后瘦素、催乳素水平差异有统计学意义（P＜0．05）；治疗后B组患者催乳素下降更明显，而瘦素增加更明显，差异有统计学意义（P＜0．05）。结论奥氮平联合齐拉西酮治疗老年精神分裂症患者可改善患者的症状，值得临床推广应用。%Objective To explore the effects of the combination use of olanzapine and ziprasidone on the glu-colipid metabolism ,serum leptin and prolactin levels in elderly schizophrenia .Methods 86 cases of elderly schizo-phrenia were included and averagely divided into two groups by the random number table .The group A was given olanzapine combined with ziprasidone ,while the group B was treated with olanzapine alone .The PANSS scores ,fast-ing blood-glucose ,HbA1c ,TG ,TC ,HDL-C ,LDL-C ,body mass ,serum leptin and luteotropin before and after treat-ment were detected and compared between the two groups .Results The PANSS scores before and after treatment showed that the PANSS scores after 1-,6-week treatment were significantly lower than that before treatment ,the difference showing statistical significance (P<0 .05) ,while the difference after treatment between the two groups had no statistical significance(P>0 .05) .Fasting blood-glucose ,HbA1c ,TG ,TC ,HDL-C ,LDL-C and body mass in the group A had no statistical difference between pre-and post-treatment(P>0 .05) ,while which in the group B showed statistical difference(P<0 .05) .Fast blood-glucose ,TC ,LDL-C and body mass after treatment in the group A had statistically significant difference(P<0 .05) ,which apparently lower than those in the group B .Compared with pre-treatment ,serum leptin and luteotropin after treatment in both groups had statistically significant difference .Prolactin decreased more significantly and leptin increased more evident in the group B after treatment ,the difference showing statistical significance ( P< 0 .05 ) .Conclusion Combination use of olanzapine and ziprasidone for treating elderly schizophrenia can improve the patient′s symptoms ,which is worthy of clinical promotion and application .