目的:分析非典型抗精神病药导致患者体质量增加与甲状腺功能的可能关系.方法:收录264名精神分裂症住院患者,符合入组标准的患者随机接受奥氮平(OLA)和利培酮(RIS)治疗,其中,服用OLA 131人,RIS 133人,观察8周,分别于基线和8周末测量患者体质量、糖脂变化和甲状腺功能.使用SPSS20.0统计软件包进行数据分析,服药后体质指数(BMI)变化影响因素采用多元回归分析,采用Spearman相关分析进行双变量相关分析.所有检验水准设定为α=0.05.结果:OLA和RIS组患者在接受8周药物治疗后,体质量、BMI、腰臀比(WHR)和空腹血糖均有显著变化(P均＜0.001);在OLA组中,甘油三酯、低密度脂蛋白和胆固醇在治疗后第8周末显著上升(P＜0.05),而甲状腺素(T4)和促甲状腺激素(TSH)显著下降(P＜0.01),与基线水平差别均具有统计学意义;在RIS组中,高密度脂蛋白、血肌酐和血清尿素氮在治疗后第8周末显著下降(P＜0.05).基线WHR和基线T4都影响了二代抗精神病药导致体质量的增加(AIWG),基线WHR和T4水平越低,患者服用抗精神病药后体质量增加越多(rs=-0.283,P=0.000;F-0.143,P=0.038).结论:精神分裂症患者药物干预前血浆TSH和T4可以预测抗精神病药物治疗后的体质量变化.%Objective:To investigate the association between antipsychotics induced weight gain (AIWG) and thyroid function of schizophrenic patients.Methods:Two hundred and sixty-four unrelated schizophrenic inpatients were selected.One hundred and thirtyone patients were treated with olanzapine (OLA),133 patients with risperidone (RIS).Patients were followed up for 8 weeks.All patients were measured for body related indices,glucose and lipid metabolism related indices and thyroid function at baseline and the end of 8 weeks after the treatment.Statistical analyses were carried out by SPSS20.0.Spearman correlation and multiple regression analyses were performed to identify factors that were correlated with AIWG.P below 0.05 was considered statistically significant.Results:After 8 weeks AAPD intervention,there were significant changes in weight,BMI,WHR and FPG (P＜0.001).In OLA group,there were significant increases in TG,LDL,CHOL (P＜0.05),and a significant decrease in TSH and T4 (P＜0.01).In RIS group,HDL,Scr and BUN were elevated after the intervention.AIWG were associated with both baseline WHR and baseline T4.The patients whose baseline WHR and baseline T4 were higher gained more weight after being treated with AAPD(rs=-0.283,P=0.000;rs=-0.143,P=0.038).Conclusion:Baseline plasma TSH and T4 can predict AIWG in schizophrenic patients.
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