氯氮平治疗精神分裂症对病人糖脂代谢、认知功能及相关因子水平的影响

徐磊; 蔡菡; 王定祥; 姜伟; 陈方方; 王小泉

doi:10.13898/j.cnki.issn.1000-2200.2023.02.027

氯氮平治疗精神分裂症对病人糖脂代谢、认知功能及相关因子水平的影响

Effect of clozapine on glucose and lipid metabolism, cognitive function and related factors in the treatment of schizophrenic patients

摘要

摘要:
目的研究氯氮平治疗精神分裂症病人对糖脂代谢、认知功能及相关因子水平影响。
方法选择入院就诊精神分裂症病人80例纳入研究，随机数字表法分为观察组和对照组，各40例，分别应用氯氮平片及利培酮片进行治疗，分析2组临床疗效，对比病人雌二醇(E2)、泌乳素(PRL)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)、空腹血糖(FPG)，以及认知功能评分。
结果干预后2组一般精神病理症状、阴性症状和阳性症状均显著低于干预前(P < 0.01)。干预后2组病人精神分裂症认知功能成套测验量表不同维度分值均较干预前增加(P < 0.05~P < 0.01)，且观察组病人工作记忆、言语学习及问题推理维度评分较对照组均明显升高(P < 0.05~P < 0.01)。治疗后，除对照组HDL-C外，2组病人血糖及血脂其他各项指标与治疗前比较差异均有统计学意义(P < 0.05~P < 0.01)，且干预后，观察组FPG、TC、TG、LDL-C均高于对照组，HDL-C低于对照组(P < 0.01)。治疗后，对照组E2降低，PRL升高(P < 0.01)，而观察组较治疗前差异无统计学意义(P>0.05)；治疗后观察组PRL低于对照组，E2高于对照组(P < 0.01)。
结论开展精神分裂症治疗时，应用氯氮平干预，可优化病人认知，对PRL影响较小，但是会产生一定糖脂代谢的影响。

Abstract:
ObjectiveTo investigate the effects of clozapine on glucose and lipid metabolism, cognitive function and related factors in the treatment of patients with schizophrenia.
MethodsA total of 80 schizophrenic patients were randomly divided into the observation group and control group(40 cases in each group), and the control group and observation group were treated with risperidone tablets and clozapine tablets, respectively.The levels of estradiol(E2), prolactin(PRL), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), total cholesterol(TC), triglyceride(TG) and fasting blood glucose(FPG), and cognitive function scores were compared between two groups.
ResultsAfter intervention, the general psychopathological symptoms, negative symptoms and positive symptoms in two groups were significantly lower than those before intervention(P < 0.01).After intervention, the scores of different dimensions of MCCB scale in two groups increased compared with those before intervention(P < 0.05 to P < 0.01), and the scores of working memory, speech learning and problem reasoning dimensions in observation group were significantly higher than those in control group(P < 0.05 to P < 0.01).Except for HDL-C in the control group, the differences of the levels of blood glucose and blood lipid in two groups between before and after treatment were statistically significant(P < 0.05 to P < 0.01).After intervention, the levels of FPG, TC, TG and LDL-C in observation group were higher than those in control group, while the HDL-C level in observation group was lower than that in control group(P < 0.01).After treatment, the E2 level decreased, and the PRL level increased in the control group(P < 0.01), while there was no statistical significance in the levels of E2 and PRL in the observation group between before and after treatment(P>0.05).After treatment, the PRL level in observation group was lower than that in control group, and the E2 level in observation group was higher than that in control group(P < 0.01).
ConclusionsIn the treatment of schizophrenia, the application of clozapine intervention can improve the patients' cognition, and has little effect on PRL, but it will have a certain impact on glucose and lipid metabolism.

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