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张 怡 邱聪龙 周东升▲ 陈 赞 陈寿林 刘灵江 徐永明 吴向平.首发精神分裂症患者治疗前后血脂、血糖水平变化的研究[J].中国现代医生,2021,59(27):25-29
首发精神分裂症患者治疗前后血脂、血糖水平变化的研究
Study on the changes of blood lipid and blood glucose levels before and after treatment of patients with first-episode schizophrenia
  
DOI:
中文关键词:  首发  精神分裂症  血脂  血糖  停药
英文关键词:First episode  Schizophrenia  Blood lipid  Blood glucose  Drug withdrawal
基金项目:浙江省宁波市医学科技计划项目(2019Y24);浙江省宁波市科技计划项目(2017C510012)
作者单位
张 怡 邱聪龙 周东升▲ 陈 赞 陈寿林 刘灵江 徐永明 吴向平 宁波市康宁医院精神科浙江宁波 315201 
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中文摘要:
      目的 观察首发精神分裂症患者治疗前后血脂、血糖水平的变化。方法 选取2017 年1 月至2018 年6 月宁波市康宁医院精神科收治的109例首发精神分裂症患者(观察组)和113 名健康体检者(对照组)作为研究对象。观察其在治疗前及治疗后1、12、18 个月时外周血中血脂、血糖水平。依据出院后有无服药,将观察组分为服药组(55例)和未服药组(54例),比较两组治疗前后的血脂、血糖水平。结果 治疗前观察组TC、TG、HDL、apoB、LPa、PLIP、LPS水平低于对照组,apoA1水平高于对照组;治疗后观察组TC、HDL、apoB、LPa、PLIP、LPS、Glu水平低于对照组,apoA1水平高于对照组;观察组治疗前后比较,HDL、apoA1、Glu水平较前下降,TG水平较前升高,差异均有统计学意义(P<0.05)。未服药组TG、apoB水平较治疗前升高;apoA1、APOE水平较治疗前下降;治疗后18 个月时,服药组HDL、LDL、apoA1、Glu水平低于治疗前,apoB、LPa水平高于治疗前;未服药组HDL、apoA1、LPS、Glu水平低于治疗前,TG、apoB、LPa水平高于治疗前,差异均有统计学意义(P<0.05)。结论 精神分裂症患者的TC、TG、HDL、apoB、LPa、PLIP、LPS水平偏低;TG水平升高预示病情好转;短期服药使HDL、apoA1、Glu水平下降,TG水平升高,长期服药使apoA1水平下降;中断服药致apoA1、LPS水平下降;停药后TG、apoB水平升高,apoA1、APOE水平降低,HDL、Glu水平恢复至未服药水平。
英文摘要:
      Objective To observe the changes of blood lipid and blood glucose levels in patients with first-episode schizophrenia before and after treatment.Methods A total of 109 patients with first-episode schizophrenia (the observation group) and 113 healthy check-ups (the control group) from the Department of Psychiatry of Ningbo Kangning Hospital from January 2017 to June 2018 were selected as the study subjects.Their blood lipid and blood glucose levels in peripheral blood before treatment and at 1 month,12 months and 18 months after treatment were observed.Based on the presence or absence of medicine-taking after discharge,the observation group was divided into a medicated group (with 55 cases) and an unmedicated group (with 54 cases),and the levels of blood lipid and blood glucose before and after treatment were compared between the two groups.Results Before treatment,the levels of serum total cholesterol (TC),triglyceride (TG),high-density lipoprotein (HDL),apolipoprotein B (apoB),Lipoproteins (LPa),phospholipids(PLIP) and lipase (LPS) in the observation group were lower than those in the control group,and apolipoprotein A1(apoA1) level was higher than that in the control group.After treatment,the levels of TC,HDL,apoB,LPa,PLIP,LPS and glucose (Glu) in the observation group were lower than those in the control group,and apoA1 level was higher than that in the control group.The observation group was compared before and after treatment,the levels of HDL,apoA1 and Glu decreased compared with those before treatment,and TG level increased compared with those before treatment.All the above-mentioned differences were statistically significant(P<0.05).In the unmedicated group,TG and apoB levels after treatment were higher than those before treatment,while apoA1 and apolipoprotein E (APOE) levels were lower than those before treatment.At 18 months after treatment,the levels of HDL,LDL,apoA1 and Glu were lower than those before treatment,while apoB and LPa levels were higher than those before treatment in the medicated group.In the un medicated group,the levels of HDL,apoA1,LPS and Glu after treatment were lower than those before treatment,while the levels of TG,apoB and LPa were higher than those before treatment.All the above-mentioned differences were statistically significant (P<0.05).Conclusion The levels of TC,TG,HDL,apoB,LPa,PLIP and LPS are low in patients with schizophrenia.The increase of TG level predicts the improvement of disease condition.Short-term medicine-taking can cause HDL,apoA1 and Glu levels to decrease,TG level to increase.Long-term medicine-taking can cause apoA1 level to decrease.Interruption of medicine-taking can cause apoA1 and LPS levels to decrease.After drug withdrawal,TG and apoB levels may increase,while apoA1 and APOE levels may decrease,and HDL and Glu levels may return to unmedicated levels.
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