CAJ | 학술논문

目的：观察精神分裂症患者服用奥氮平后体重指数（BMI）和血糖变化，以及二甲双胍防治奥氮平所致糖代谢异常的作用。方法选择83例初次确诊精神分裂症患者，分为奥氮平单独治疗组（对照组42例）和二甲双胍联合奥氮平治疗组（联合治疗组41例），观察治疗前后两组BMI、空腹血糖和餐后2 h血糖水平变化。结果联合治疗组BMI、餐后2 h血糖治疗前后差异有统计学意义（t分别=40.50、4.95，P均＜0.05）；空腹血糖治疗前后差异无统计学意义（t=0.24，P＞0.05）。对照组BMI、空腹血糖、餐后2 h血糖治疗前后差异有统计学意义（t分别=59.85、10.23、10.13，P均＜0.05）；治疗后两组患者BMI间差异无统计学意义（t=0.01，P＞0.05），平均空腹血糖和平均餐后2 h血糖差异有统计学意义（t分别=4.51、8.77，P均＜0.05）。治疗期间对照组患者的糖尿病发生率明显高于联合治疗组，差异有统计学意义（χ2=2.51，P＜0.05）。结论奥氮平可以增加精神分裂症患者BMI、空腹和餐后血糖，增加患糖尿病的风险，合并使用二甲双胍可以降低奥氮平导致的空腹以及餐后血糖升高和罹患糖尿病的风险。
목적：관찰정신분렬증환자복용오담평후체중지수（BMI）화혈당변화，이급이갑쌍고방치오담평소치당대사이상적작용。방법선택83례초차학진정신분렬증환자，분위오담평단독치료조（대조조42례）화이갑쌍고연합오담평치료조（연합치료조41례），관찰치료전후량조BMI、공복혈당화찬후2 h혈당수평변화。결과연합치료조BMI、찬후2 h혈당치료전후차이유통계학의의（t분별=40.50、4.95，P균＜0.05）；공복혈당치료전후차이무통계학의의（t=0.24，P＞0.05）。대조조BMI、공복혈당、찬후2 h혈당치료전후차이유통계학의의（t분별=59.85、10.23、10.13，P균＜0.05）；치료후량조환자BMI간차이무통계학의의（t=0.01，P＞0.05），평균공복혈당화평균찬후2 h혈당차이유통계학의의（t분별=4.51、8.77，P균＜0.05）。치료기간대조조환자적당뇨병발생솔명현고우연합치료조，차이유통계학의의（χ2=2.51，P＜0.05）。결론오담평가이증가정신분렬증환자BMI、공복화찬후혈당，증가환당뇨병적풍험，합병사용이갑쌍고가이강저오담평도치적공복이급찬후혈당승고화리환당뇨병적풍험。
Objective To observe body mass index and blood sugar changes before and after taking olanzapine, and the prevention effect of metiformin for impaired glucose metabolism caused by olanzapine. Methods Totally 83 schizophrenic were enrolled, divided to olanzapine group(O group,42 cases) and metformin joint olanzapine group(M+O group, 41 cas-es). BMI, fasting blood-glucose and postprandial blood sugar changes before and after treatment were observed. Results After 6 month treatments, BMI and postprandial blood sugar had statistic differences in M+O group compared with those before treatment(t=40.50,4.95,P<0.05); fasting blood-glucose had no statistic differences(t=0.24,P>0.05). After treat-ments, BMI, fasting blood-glucose, and postprandial blood sugar had statistic differences in O group compared with those before treatment (t=59.85,10.23,10.13,P<0.05);No significant statistic difference were found in BMI between the two groups after treatment (t=0.01,P>0.05);there were significant differences in fasting blood-glucose and postprandial blood sugar between the two groups after treatment(t=4.51,8.77,P<0.05). The incidence of diabetes had statistic difference be-tween the two groups (χ2=2.51,P<0.05). Conclusions The BMI, fasting blood-glucose, postprandial blood sugar and risk of diabetes were increased after olanzapine treatment; coadministration metiformin is helpful to control the fasting blood-glucose, postprandial blood sugar and risk of diabetes caused by olanzapine.