【摘要】：目的： 1.探討利培酮引發(fā)精神分裂癥患者體重增加的特點(diǎn)及相關(guān)因素。 2.探討利培酮對(duì)精神分裂癥患者代謝指標(biāo)的影響效應(yīng)及相關(guān)因素。 方法： 第一部分對(duì)115例住院精神分裂癥患者進(jìn)行為期24周的利培酮治療觀察,每2周測(cè)量1次身高、體重及評(píng)估1次陽(yáng)性與陰性癥狀量表以及食量、睡眠量、活動(dòng)量的變化情況等。 第二部分 對(duì)56例住院精神分裂癥患者予以利培酮治療16周,每2周測(cè)量1次腰圍、血壓及評(píng)估1次陽(yáng)性與陰性癥狀量表,入組后次日及8周末、16周末各測(cè)定1次空腹血糖、血脂及餐后2小時(shí)血糖等；并與36例健康者做對(duì)照。 結(jié)果： 第一部分 1.體重增加的發(fā)生率為61.74%(71例),其中91.55%發(fā)生在16周內(nèi)：體重增加組的體重指數(shù)于4～12周快速上升,16周內(nèi)上升幅度占總升幅的89.18%,20周后不再顯著性上升(P0.05)。 2.影響體重指數(shù)上升率的因素為用藥史、肥胖家族史、食量變化、基線體重指數(shù)。 第二部分 1.患者組治療后腰圍、甘油三酯、餐后2小時(shí)血糖較治療前顯著性上升,高密度脂蛋白顯著性降低,變化值與對(duì)照組比較差異有顯著性(P0.05)；血壓、空腹血糖治療前后差異無(wú)顯著性(P0.05)。 2.患者組代謝綜合征的發(fā)生率為12.50%(7例),腰圍、甘油三酯、高密度脂蛋白及餐后2小時(shí)血糖異常率分別為39.29%、21.43%、12.50%及19.64%,與對(duì)照組比較均差異有顯著性(P0.05)；血壓、空腹血糖異常率分別為8.93%及5.36%,與對(duì)照組比較差異無(wú)顯著性(P0.05)。3.發(fā)生代謝綜合征的危險(xiǎn)因素為糖尿病家族史及年齡,發(fā)生腰圍超標(biāo)、甘油三酯異常、餐后2小時(shí)血糖異常的危險(xiǎn)因素分別為基線腰圍及肥胖家族史、基線甘油三酯及基線收縮壓、基線腰圍及年齡。 結(jié)論： 第一部分 1.利培酮可引發(fā)精神分裂癥患者普遍的體重增加,集中出現(xiàn)在用藥后的前4個(gè)月；體重上升在前3個(gè)月最快、至少持續(xù)半年。 2.未用過(guò)抗精神病藥物、有肥胖Ⅰ級(jí)家族史、用藥后食量明顯增多及體型偏瘦的精神分裂癥患者,接受利培酮治療后易發(fā)生體重增加。 第二部分 1.利培酮可引發(fā)精神分裂癥患者腹型肥胖和糖脂代謝紊亂乃至代謝綜合征。 2.對(duì)年齡大、有糖尿�、窦�(jí)家族史及體態(tài)較胖的精神分裂癥患者,應(yīng)慎用利培酮。
[Abstract]:Objective: 1. To investigate the characteristics and related factors of weight gain in patients with schizophrenia induced by risperidone. 2. To investigate the effect of risperidone on metabolic indexes in schizophrenic patients and its related factors. Methods: in the first part, 115 inpatients with schizophrenia were treated with risperidone for 24 weeks. Height, weight, positive and negative symptom scale, food intake, sleep volume were measured once every 2 weeks. A change in activity, etc. In the second part, 56 inpatients with schizophrenia were treated with risperidone for 16 weeks, waist circumference was measured once every 2 weeks, blood pressure and positive and negative symptoms were evaluated once. Fasting blood glucose, blood lipids and 2 hours postprandial blood glucose were measured once on the next day and at the 16th weekend of the 8th weekend, respectively, and were compared with 36 healthy subjects. Results: part 1. The incidence of body weight gain was 61.74% (71 cases), of which 91.55% occurred within 16 weeks. The body mass index (BMI) of the weight gain group increased rapidly at 4 ~ 12 weeks and accounted for 89.18% of the total increase within 16 weeks (P0.05). 2. The factors influencing the increase of BMI were the history of medication, family history of obesity, changes of food intake and baseline BMI. Part 1. After treatment, the waist circumference, triglyceride, 2 hours postprandial blood glucose in the patients group were significantly higher than those before treatment, and the HDL level was significantly lower than that in the control group (P0.05), blood pressure, blood pressure, There was no significant difference in fasting blood glucose before and after treatment (P0.05). 2. The incidence of metabolic syndrome was 12.50% (7 cases). The abnormal rates of waist circumference, triglyceride, high density lipoprotein and 2 hours postprandial blood glucose were 39.29 and 21.43%, 12.50% and 19.64, respectively. The abnormal rates of fasting blood glucose were 8.93% and 5.36%, respectively. There was no significant difference compared with the control group (P0.05). 3. The risk factors of metabolic syndrome were family history and age of diabetes mellitus, excess waist circumference, abnormal triglyceride and 2 hours postprandial blood glucose abnormality. The risk factors of metabolic syndrome were baseline waist circumference and family history of obesity. Baseline triglyceride and baseline systolic blood pressure, baseline waist circumference and age. Conclusion: part 1. Risperidone can trigger general weight gain in schizophrenic patients, concentrated in the first four months after medication; weight gain is fastest in the first three months, lasting at least half a year. 2. Patients with schizophrenia who had not used antipsychotic drugs and had a family history of obesity grade 鈪，

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