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目的:探讨服用非典型抗精神病药物奥氮平4周对首发精神分裂症患者体质指数、血浆瘦素及下丘脑食欲调节系统神经激素的水平的影响.方法:38例在我院就诊的符合DSM-Ⅳ诊断标准的首发精神分裂症患者,采用奥氮平单药治疗4周,测定患者服用奥氮平前后的体质指数、血脂血糖以及神经激素等,并与正常对照组比较.结果:奥氮平治疗4周后,患者的体质量、体质指数与治疗前相比有明显的增加(P < 0.01),血浆中的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL) 水平均有明显的升高(P < 0.05).患者血浆中的瘦素(Leptin)及神经肽Y(NPY)水平经奥氮平治疗后都明显增加(P < 0.05),而治疗前患者的NPY水平明显低于正常对照组(P <0.05).患者无论治疗前或治疗后的α-促黑细胞刺激素(α-MSH)水平都明显低于对照组(P 0.05).结论:精神分裂症患者早期使用奥氮平治疗会引起血浆瘦素及下丘脑神经激素水平的改变,从而引起体质量的增加.“,”Objective:To investigate the effects of an atypical antipsychotic drug olanzapine on the body mass index(BMI), leptin and hypothalamic neurohormone related to appetite regulation in the first-attack psychotic patients after 4-week treatment. Methods:Totally 38 first-attack psychotic patients meeting DSM-Ⅳ diagnostic criteria were treated with olanzapine for 4 weeks. The BMI,blood lipids,blood glucose and neurohormone were measured before and after the treatment. The normal control group was also considered the above indices. Results:After the 4-week treatment, the body weight and the body mass index increased significantly when compared with those before the treatment (P < 0.01),and the plasma levels of TC,TG and LDL were higher than those before the treatment(P < 0.05). Both leptin and NPY levels significantly increased in the patients after the treatment (P <0.05),while the NPY levels were significantly lower before the treatment when compared with those in the control group(P< 0.05). The α-MSH levels before and after the treatment were significantly lower than those in the control group(P 0.05). Conclusion:The levels of leptin and neurohormone may be changed in the early treatment of olanzapine in the patients with schizophrenia,which may cause weight gain.