阿立哌唑与奥氮平对精神分裂症患者血糖、血脂影响的Meta分析

Effect of Aripiprazole and Olanzapine on blood glucose and lipids of patients with schizophrenia: meta-analysis

摘要:

目的  利用Meta分析的方法评估阿立哌唑与奥氮平对精神分裂症患者血糖、血脂的差异。方法  计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Elsevier、Cochrane Library等并手工检索杂志、书籍等相关资料，检索时间为2011年1月1日-2015年7月31日，对有关阿立哌唑与奥氮平治疗精神分裂症患者的随机对照研究资料进行全面收集，在质量评价的基础上，利用RevMan 5.2软件进行Meta分析。结果  共纳入9篇随机对照研究（915例患者）进行Meta分析，结果显示，干预结束后服用奥氮平的精神分裂症患者空腹血糖要高于阿立哌唑组[MD=-0.37，95%CI（-0.53，-0.21）]，差异有统计学意义（P =0.000）；干预结束后奥氮平组的血三酰甘油水平要高于阿立哌唑组[MD=-0.22，95%CI（-0.29，-0.15）]，差异有统计学意义（P =0.000）；干预结束后服用奥氮平组的血胆固醇水平要高于阿立哌唑组[MD=-0.42，95%CI（-0.54，-0.29）]，差异有统计学意义（P =0.000）。结论  奥氮平较阿立哌唑更易引起精神分裂症患者血糖、血脂紊乱。

Abstract:

Objective To evaluate the side effects of Aripiprazole and Olanzapine on blood glucose and blood lipids of patients with schizophrenia using meta-analysis. Methods The databases such as CBM, VIP, CNKI, WanFang, PubMed, Elsevier and Cochrane Library, etc. were searched to collect randomized controlled trials (RCTs) from January 1, 2011 to July 31, 2015, and the relevant Internet literature and books were also searched by hand. The literature quality was independently evaluated and cross-checked by three reviewers according to the Cochrane collaboration bias scale, and meta-analysis was applied to the results of homogeneous studies with RevMan 5.2 software. Results A total of 9 randomized controlled studies (915 patients) were included. The meta-analysis results showed that the levels of fasting blood glucose, triglycerides and cholesterol of the patients with schizophrenia significantly increased after taking regular doses of Olanzapine compared to those taking Aripiprazole (P < 0.05). Conclusions Aripiprazole is more secure than Olanzapine in aspects of blood glucose, blood lipids and other side-reactions in patients with schizophrenia.