阿卡波糖对奥氮平所致精神分裂症患者体质量增加影响的对照研究 联系客服

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阿卡波糖对奥氮平所致精神分裂症患者体质量增加影响的对照研究

作者:高志文 童庆好 宋莉莉 来源:《医学信息》2016年第20期

摘要:目的 探讨阿卡波糖用于治疗精神分裂症患者在奥氮平治疗后出现的体质量增加及代谢改变的有效性。方法 接受奥氮平单药治疗、并出现有临床意义体重显著增加(≥7%)的精神分裂症患者随机分为两组,分别加用阿卡波糖300mg/d(阿卡波糖组,n=26)、二甲双胍750mg/d(对照组,n=26)辅助治疗,于治疗前及治疗后4、8周末测定体质量指数(BMI)、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)及稳态模型评估的胰岛素抵抗指数(HOMA-IR)。结果 ①阿卡波糖组8w时BMI较治疗前显著下降(t=2.309,P0.05)。②阿卡波糖组治疗后FPG无显著改变(均P>0.05),对照组8w时FPG显著下降(t=2.280,P0.05);两组治疗4、8 w时的HOMA-IR均较治疗前显著下降(t=2.177-2.500,均P0.05)。结论 阿卡波糖可降低奥氮平所致体质重增加,疗效与二甲双胍相近、但起效慢;对代谢紊乱也有改善作。

关键词:阿卡波糖;二甲双胍;精神分裂症;体质量;代谢紊乱;奥氮平

Abstract:Objective This study was to assess the efficacy of acarbose on relief of olanzapine-induced weight gain and metabolic dysfunction.Methods In the 8 week controlled study,

schizophrenic patients suffering from olanzapine-induced weight gain were randomly divided into two treatment groups,one with acarbose (300mg/d, acarbose group,n=26 ),one with metformin (750 mg/d, control group,n=26 ). The body mass index (BMI),fasting plasma glucose (FPG),TG, TC and homeostasis model assessment of insulin resistance index (HOMA-IR) were measured from baseline to week 4,8 after treatment.Results There was a significant decrease in BMI from baseline to week 8 in acarbose group(t=2.309, P0.05).After 8 week intervent-ion , FPG was significantly decreased in control group(t=2.280,P0.05).TG was lower at 4 weekend (t=2.499,2.431 ;both P0.05). The HOMA-IR were significantly lower from baseline to week 4.8 in both two group (t=2.177-2.500 ,all P0.05).Conclusion Acarbose addition therapy has a considerable but later effectiveness in attenuating olanzapine-induced weight gain compared to metformin, and has a benefit on relief of metabolic dyfunction in schizophrenia patients. Key words:Acarbose ;Metformin; Weight; Metabolic dysfunction;Olanzapine

体质量显著增加是精神分裂症患者在接受奥氮平治疗过程中最为常见的不良反应之一,其产生既可加剧患者的病耻感、影响精神分裂症患者回归社会的进程,同时也是患者对治疗抵抗、中断治疗而引起病情复发的重要原因[1]。通过生活方式及药物联合干预来延缓奥氮平导致的药源性肥胖,有较好的效果[2]。而药物干预措施中,目前以二甲双胍的使用最为广泛,