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SCI REP: 长期使用氯氮平对精神分裂症患者的骨密度具有保护作用

2019-03-09 不详 MedSci原创

精神分裂症患者中低骨密度(BMD)的发生风险较高。而有文献报道抗精神病药物的使用在BMD中起重要作用。以前的横断面研究表明,氯氮平治疗可能有益于精神分裂症患者的BMD治疗。然而,长期氯氮平治疗对BMD的影响仍然未知。因此,本项前瞻性研究比较了氯氮平和非氯氮平抗精神病药对精神分裂症患者和女性BMD的长期影响。

背景及目的:
精神分裂症患者中低骨密度(BMD)的发生风险较高。而有文献报道抗精神病药物的使用在BMD中起重要作用。以前的横断面研究表明,氯氮平治疗可能有益于精神分裂症患者的BMD治疗。然而,长期氯氮平治疗对BMD的影响仍然未知。因此,本项前瞻性研究比较了氯氮平和非氯氮平抗精神病药对精神分裂症患者和女性BMD的长期影响。

方法:
精神分裂症患者和根据年龄匹配的健康对照组分别从医疗中心中招募。纳入标准为:所有患者,包括氯氮平接受者和非氯氮平抗精神病药物接受者,在入组时和随访期间保持临床稳定,未改变抗精神病药物和剂量至少6个月。在入组和1年或3年随访时通过双能X射线检查BMD的发生率。

结果:
在入组和随访时,接受氯氮平的患者的平均BMD高于非氯氮平患者的平均BMD。总体而言,氯氮平组患者获得BMD完整性较高,而非氯氮平组患者1 - 3年后BMD丢失情况严重(p = 0.015)。接受氯氮平治疗的患者与健康对照之间的BMD变化没有显着差异。氯氮平组BMD变化相关因素包括钙水平(B = -0.607,p = 0.015)。

结论:
这项研究表明,与精神分裂症患者中的催乳素升高和非氯氮平保留催乳素的抗精神病药物相比,长期氯氮平治疗可以保护BMD的完整性。

原始出处:

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