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目的观察瑞波西汀治疗氯氮平所致代谢综合征的疗效和不良反应。方法筛选110例长期住院的男性慢性精神分裂症患者,采用随机双盲法将其分为研究组和对照组,每组55例,试验期间原氯氮平剂量不变,分别于治疗前及治疗后4、8、16、24周末测定体重、体重指数(BMI)、腰围、臀围、腰臀比(WHR)、空腹血糖、血脂、血浆胰岛素(INS)水平等指标,采用阳性与阴性症状量表(PANSS)评定疗效;于治疗前及治疗后2、4、8、16、24周末以不良反应量表评定不良反应。结果治疗24周后,研究组患者体重、BMI、腰围、臀围、WHR均较治疗前明显下降,差异有统计学意义(t=2.63,P﹤0.01、t=2.71,P<0.01、t=2.89,P﹤0.01、t=3.02,P﹤0.01、t=1.98,P﹤0.05)。TG、TC、低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)、血浆胰岛素(INS)较治疗前有明显下降,差异有统计学意义(t=2.67,P﹤0.01;t=2.75,P﹤0.01;t=2.68,P﹤0.01;t=2.78,P﹤0.01;t=3.02,P﹤0.01)。HDL高于治疗前,差异有统计学意义(t=2.25,P﹤0.05),血糖无明显改变,差异无统计学意义(t=1.25,P﹥0.05)。结论瑞波西汀治疗氯氮平所致代谢综合征安全有效。
Objective To observe the curative effect and adverse reactions of reboxetine on clozapine-induced metabolic syndrome. Methods A total of 110 chronic schizophrenia patients were enrolled in this study. The patients were divided into study group and control group by randomized double-blind method, with 55 cases in each group. The dosage of raw clozapine remained unchanged before treatment and after treatment Body weight, BMI, WHR, fasting blood glucose, blood lipids and plasma insulin (INS) were measured at the end of the 4,8,16,24weeks. The positive and negative symptoms Table (PANSS) assessment of efficacy; before treatment and 2,4,8,16,24 weeks after treatment with adverse reaction scale assessment of adverse reactions. Results After 24 weeks of treatment, the body weight, BMI, waist circumference, hip circumference and WHR in study group were significantly lower than those before treatment (t = 2.63, P <0.01, t = 2.89, P <0.01, t = 3.02, P <0.01, t = 1.98, P <0.05). TG, TC, LDL, VLDL and INS were significantly lower than those before treatment (t = 2.67, P <0.01; t = 2.75 , P <0.01; t = 2.68, P <0.01; t = 2.78, P <0.01; t = 3.02, P <0.01). HDL was higher than before treatment, the difference was statistically significant (t = 2.25, P <0.05), no significant change in blood glucose, the difference was not statistically significant (t = 1.25, P> 0.05). Conclusion Reboxetine is safe and effective in treating clozapine-induced metabolic syndrome.