| 刘瑾,吴善武.二甲双胍联合利培酮治疗精神分裂症伴发代谢综合征的疗效及对患者Hcy、APN、LEP水平的影响.[J].中南医学科学杂志.,2025,(6):1125-1128. |
| 二甲双胍联合利培酮治疗精神分裂症伴发代谢综合征的疗效及对患者Hcy、APN、LEP水平的影响 |
| Efficacy of metformin combined with risperidone in the treatment of schizophrenia with metabolic syndrome and its effects on Hcy, APN and LEP levels |
| 投稿时间：2024-10-18 |
| DOI：10.15972/j.cnki.43-1509/r.2025.06.046 |
| 中文关键词: 二甲双胍 利培酮 精神分裂症 代谢综合征 同型半胱氨酸 |
| 英文关键词:metformin risperidone schizophrenia metabolic syndrome homocysteine |
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| 中文摘要: |
| 目的观察二甲双胍联合利培酮治疗精神分裂症伴发代谢综合征(MS)的疗效及对患者同型半胱氨酸(Hcy)、脂联素(APN)、瘦素(LEP)水平的影响。 方法将精神分裂症伴发MS患者82例随机均分为利培酮组和联合组。两组均给予精神康复联合饮食控制,利培酮组给予利培酮治疗,联合组给予二甲双胍联合利培酮治疗,两组均连续用药12周。比较两组疗效及Hcy、APN、LEP、腰臀比(WHR)、体质指数(BMI)、代谢相关指标及阳性和阴性症状量表(PANSS)评分差异,统计两组不良反应发生情况。 结果联合组治疗总有效率高于利培酮组(P＜0.05),治疗后联合组Hcy、LEP下降,且低于利培酮组(P＜0.05)；APN升高,且高于利培酮组治疗后(P＜0.05)。治疗后联合组空腹血糖(FBG)、BMI、甘油三酯(TG)、WHR、总胆固醇(TC)及胰岛素抵抗指数(HOMA-IR)下降,且低于利培酮组(P＜0.05),高密度脂蛋白(HDL)升高,且高于利培酮组治疗后(P＜0.05)。两组治疗后阳性症状、阴性症状、一般精神病理症状及PANSS总分均下降(P＜0.05)。两组不良反应比较差异无统计学意义(P＞0.05)。 结论二甲双胍联合利培酮治疗精神分裂症伴发MS可调节代谢指标和Hcy、APN、LEP的表达,降低WHR和BMI,且不增加不良反应。 |
| 英文摘要: |
| AimTo observe the efficacy of metformin combined with risperidone in treating schizophrenia with metabolic syndrome (MS) and its effects on homocysteine (Hcy), adiponectin (APN), and leptin (LEP) levels. MethodsEighty-two patients with schizophrenia and MS were selected and randomly divided into a risperidone group and a combination group. Both groups received psychiatric rehabilitation combined with dietary control. The risperidone group was treated with risperidone alone, while the combination group received metformin combined with risperidone. Both groups were treated continuously for 12 weeks. The differences in efficacy, Hcy, APN, LEP, waist-to-hip ratio (WHR), body mass index (BMI), metabolism-related indicators, and Positive and Negative Syndrome Scale (PANSS) scores were compared between the two groups, and the incidence of adverse reactions in both groups was analyzed. ResultsThe total effective rate of the combined group was higher than that of the risperidone group (P＜0.05). After treatment, Hcy and LEP levels were decreased in the combination group and were lower than those in the risperidone group (P＜0.05), while APN levels were increased and were higher than those in the risperidone group (P＜0.05). After treatment, fasting plasma glucose (FBG), BMI, triglyceride (TG), WHR, total cholesterol (TC), and homeostasis model assessment of insulin resistance (HOMA-IR) were decreased in the combination group and were lower than those in the risperidone group (P＜0.05), while high-density lipoprotein (HDL) were increased and was higher than that in the risperidone group (P＜0.05). The positive symptoms, negative symptoms, general psychopathology scores, and total PANSS scores were decreased after treatment in both groups (P＜0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P＞0.05). ConclusionMetformin combined with risperidone as a method for the treatment of schizophrenia with MS can regulate metabolic indicators and the expression of Hcy, APN, and LEP, and reduce WHR and BMI, without increasing adverse reactions. |
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