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氯丙嗪与氯氮平所致代谢综合征的患病率及相关因素差异:一项对男性中国队列的 10 年回顾性研究。

Differing Prevalence and Correlates of Metabolic Syndromes Between Chlorpromazine and Clozapine: A 10-year Retrospective Study of a Male Chinese Cohort.

机构信息

Shanghai Mental Health Center, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.

The First Minzheng Mental Health Center. Shanghai, China.

出版信息

Curr Neuropharmacol. 2022;20(10):1969-1977. doi: 10.2174/1570159X20666220302153123.

Abstract

BACKGROUND

Antipsychotics are known to be associated with metabolic syndromes (MetS). Chlorpromazine (CPZ) and Clozapine (CLZ) are currently the most commonly used antipsychotics in low-income districts of China. However, potential differences in the long-term effects of CPZ and CLZ on MetS in schizophrenia inpatients are not well understood. Here, we aimed to identify any MetS profile differences between long-term schizophrenia patients who were prescribed either CPZ or CLZ at a primary psychiatric hospital.

METHODS

We recruited a total of 204 male schizophrenia patients who received either CPZ or CLZ. We measured their weight, height, body mass index (BMI), waist circumference (WC), diastolic blood pressure (DBP), and systolic blood pressure (SBP), as well as their biochemical indicators, including fasting blood glucose (FBS), triglycerides (TG), cholesterol (TC), high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c).

RESULTS

The MetS prevalence in the CPZ and CLZ groups was 31% and 37.5%, respectively. The CLZ group had significantly higher DBP levels and a higher incidence of dyslipidemia (HDL-c) but lower HDL-c and TC levels than the CPZ group. We also determined that smoking history, BMI, and duration of hospitalisation were risk factors for the development of MetS. Moreover, we found that CPZ and CLZ were correlated with the same risk for developing MetS and that BMI was a vital risk factor of MetS for both the CPZ and CLZ groups.

CONCLUSION

Long-term CPZ and CLZ prescriptions were associated with similar profiles for developing MetS of schizophrenia patients.

摘要

背景

抗精神病药物已知与代谢综合征(MetS)有关。氯丙嗪(CPZ)和氯氮平(CLZ)是目前中国低收入地区最常用的抗精神病药物。然而,CPZ 和 CLZ 对精神分裂症住院患者代谢综合征的长期影响的潜在差异尚不清楚。在这里,我们旨在确定在一家主要精神病医院接受 CPZ 或 CLZ 长期治疗的精神分裂症患者之间是否存在代谢综合征特征差异。

方法

我们共招募了 204 名接受 CPZ 或 CLZ 治疗的男性精神分裂症患者。我们测量了他们的体重、身高、体重指数(BMI)、腰围(WC)、舒张压(DBP)和收缩压(SBP),以及他们的生化指标,包括空腹血糖(FBS)、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-c)和低密度脂蛋白胆固醇(LDL-c)。

结果

CPZ 和 CLZ 组的代谢综合征患病率分别为 31%和 37.5%。CLZ 组的 DBP 水平显著较高,且血脂异常(HDL-c)的发生率较高,但 HDL-c 和 TC 水平较低。我们还确定了吸烟史、BMI 和住院时间是代谢综合征发展的危险因素。此外,我们发现 CPZ 和 CLZ 与代谢综合征的发生具有相同的相关性,并且 BMI 是 CPZ 和 CLZ 两组代谢综合征的重要危险因素。

结论

长期 CPZ 和 CLZ 处方与精神分裂症患者代谢综合征的发展具有相似的特征。

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