【关键词】  精神分裂症；利培酮；氯氮平；血脂

　　【摘要】  目的  探讨利培酮与氯氮平对首发精神分裂症患者血脂的影响。 方法  将118例首发精神分裂症患者随机分为利培酮组58例，氯氮平组60例，于治疗前及治疗第4、8、12w末晨间空腹采血，并进行血脂检测比较。用药剂量根据病情加减，但2w内应加至有效治疗量。 结果  氯氮平组8w末血脂显著上升，12w末稍有下降；利培酮组4w末血脂稍有升高，第8、12w末无显著变化。 结论  利培酮与氯氮平对首发精神分裂症患者血脂均有影响，但利培酮影响较轻。

　　【关键词】  精神分裂症；利培酮；氯氮平；血脂

　　Effects of risperidone vs clozapine on bloodlipid of firstepisode schizophrenia

　　【Abstract】 Objective  To explore the effects of risperidone vs clozapine on bloodlipid of firstepisode schizophrenia. Methods 118 firstepisode schizophrenics were randomly divided into the risperidone group(n=58) and clozapine group(n=60), fasting bloods in the early morning were took before treatment and at the ends of 4th, 8th and 12th week of treatment to compare the bloodlipid. Dosage was increased or decreased according to patients' condition, but should be added to effective therapeutic dose within 2 weeks. Results The bloodlipids rose at the end of 8th week and slightly dropped at the 12th in the clozapine group; those slightly rose at the end of the 4th week and had no significant changes at the 8th and 12th in the risperidone group. Conclusion Both risperidone and clozapine affects bloodlipid of firstepisode schizophrenia, but effects of the former is milder.

　　【Keywords】 Schizophrenia; risperidone; clozapine; bloodlipid

　　利培酮与氯氮平均为非典型抗精神病药物,在临床上已广泛应用。氯氮平长期应用可导致患者体重增加及心血管疾病等；利培酮的应用缺少相关报道。为此，我们对利培酮与氯氮平治疗的首发精神分裂症患者的血脂水平进行了动态观察，现报告如下。

　　1 对象与方法

　　1.1 对象  选择2000年1月～2004年1月我院住院的118例首发精神分裂症患者为研究对象。符合《中国精神障碍分类与诊断标准》第3版（CCMD3）精神分裂症诊断标准，入组前未服用任何抗精神病药，均经患者及家属知情同意。排除严重躯体疾病、脑器质性疾病、成瘾物质滥用及药物过敏者。入组病例均为男性,随机将118例患者分为两组，氯氮平组60例,平均年龄24.6±10.2a；利培酮组58例,平均年龄23.8±11.1a,两组年龄无显著性差异。

　　1.2 方法  采用治疗前后对照法进行检测分析。治疗剂量根据病情加减，2w内应加至有效治疗量。用药前与用药第4、8、12w末采集空腹血液标本进行血脂测定。研究期间不合并激素等影响血脂的药物，患者进行普食管理。

　　1.3 统计方法  计量资料采用t检验，计数资料采用χ2检验。

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