本刊首页 > 期刊目次 > 阿立哌唑联合氯氮平对长期住院精神分裂症患者Asprosin及糖脂代谢的影响

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阿立哌唑联合氯氮平对长期住院精神分裂症患者Asprosin及糖脂代谢的影响

  • 黄敏

* 通信作者: 黄敏, 单位:安庆市精神病医院

摘要


目的 探讨阿立哌唑联合氯氮平对长期住院精神分裂症患者白脂素(Asprosin)、糖脂代谢及疗效的影响。

方法 选择 2019年1 月至 2019年 12月在我院长期住院治疗的精神分裂症患者作为研究对象,其中对照组48例,研究组47例。对照组患者采用氯氮平口服治疗,初始剂量为25mg/d,逐渐缓慢增加至200-400 mg/d。研究组患者在氯氮平治疗基础上采用阿立哌唑口崩片进行治疗,阿立哌唑口崩片初始口服剂量为5mg/d,逐渐缓慢增加至20mg/d,氯氮平减量至50mg-100mg/d,两组患者药物疗程均为24周。比较两组患者治疗前后阳性和阴性症状量表(PANSS)评分变化,Asprosin、空腹血糖(FPG)、糖化血红蛋白(HbA1C)、总胆固醇(TC)、甘油三酯(TG)、高密高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)变化,并对Asprosin变化情况与代谢指标采用Pearson 相关分析及多元线性回归进行分析。

结果 治疗后2组患者PANSS各项评分均较治疗前降低,其中研究组各项评分较对照组低,差异具有统计学意义(P<0.05),药物治疗后两组患者血清Asprosin、FPG、HbA1C、TC、TG、LDL-C水平均较药物治疗前升高,其中对照组患者血清Asprosin、FPG、HbA1C、TC、TG、LDL-C水平均较研究组患者高,差异具有统计学意义(P<0.05),ΔAsprosin与ΔFPG、ΔHbA1C、ΔLDL-C,呈正相关,差异具有统计学意义(P<0.05),进一步以ΔAsprosin为因变量,进行多元线性回归,

结果显示ΔFPG、ΔHbA1C、ΔLDL-C为对照组患者治疗后血清Asprosin变化的独立影响因素。

结论:长期住院精神分裂症采用阿立哌唑联合氯氮平治疗有利于降低其发生糖脂代谢紊乱的风险,临床上应当关注此类患者药物治疗时Asprosin这类脂肪因子调节的变化,以期进一步降低其发生糖脂代谢紊乱的风险。

关键词:关键词:阿立哌唑;氯氮平;精神分裂症;白脂素

ABSTRACT


Objective To investigate the effects of aripiprazole combined with clozapine on the Asprosin, glucolipid metabolism and curative effects of long-stay schizophrenics.

Methods The schizophrenics who received long-term hospitalization in our hospital from January 2019 to December 2019 were selected as the research objects. They were divided into the control group with 48 cases and the research group with 47 cases, respectively. The patients in the control group were treated with clozapine for oral medication. The predose was 25mg/d, which gradually increased to 200-400 mg/d. The patients in the research group were treated with orally disintegrating tablets of aripiprazole based on the oral administration of clozapine. The predose of aripiprazole was 5mg/d, which gradually increased to 20mg/d, and the dose of clozapine was reduced to 50mg-100mg/d. The course of treatment for the two groups was 24 weeks. The changes in the scores of positive and negative syndrome scale (PANSS) before and after treatment between the two groups of patients were compared. The changes in Asprosin, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1C), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) between the two groups were also compared. Pearson correlation analysis and multiple linear regression were used to analyze the changes of Asprosin and metabolic indexes.

Results The PANSS scores of the two groups were lower than that before treatment. The research group had lower scores than the control group, with significant differences (P<0.05). The level of Asprosin, FPG, HbA1C, TC, TG and LDL-C in the serum of patients in the two groups were higher after drug treatment. To be specific, the patients in the control group had higher level of Asprosin, FPG, HbA1C, TC, TG and LDL-C than those in the research group, with significant differences (P<0.05). ΔAsprosin was positively correlated with ΔFPG, ΔHbA1C and ΔLDL-C, with significant differences (P<0.05). Multiple linear regression was conducted, with ΔAsprosin as the dependent variable. The results showed thatΔFPG, ΔHbA1C and ΔLDL-C were the independent influence factors for Asprosin changes of the patients in the control group after treatment.

Conclusion   The long-stay schizophrenics can receive aripiprazole combined with clozapine for treatment, which helps to lower the risk of glucolipid metabolism disorder. Clinically, the changes in the regulation of adipocytokines such as Asprosin during the drug treatment of such patients should be paid attention to, so as to further reduce the risk of glucolipid metabolism disorder.

Key words: Keywords:Aripiprazole;Clozapine;schizophrenic;overweight;Asprosin

引用本文 / How to Cite This Article

黄敏.阿立哌唑联合氯氮平对长期住院精神分裂症患者Asprosin及糖脂代谢的影响[J]. 国际精神病学杂志, , (): -

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