目的 觀(guān)察對(duì)比帕利哌酮緩釋片與利培酮片對(duì)女性首發(fā)精神分裂癥患者糖脂代謝影響。方法 將85例在德陽(yáng)市精神衛(wèi)生中心治療的女性首發(fā)精神分裂癥患者隨機(jī)分為觀(guān)察組42例和對(duì)照組43例，分別給予帕利哌酮緩釋片和利培酮片單藥治療2個(gè)月。治療前后測(cè)量體質(zhì)量指數(shù)（BMI）、腰圍、三酰甘油（TG）、總膽固醇（TC）、高密度脂蛋白（HDLC）、低密度脂蛋白（LDLC）、空腹血糖（FPG）、餐后2 h血糖（2 h PG），采用陽(yáng)性和陰性癥狀量表（PANSS）進(jìn)行療效評(píng)價(jià)。結(jié)果 治療前兩組PANSS總分及各因子分（陽(yáng)性癥狀、陰性癥狀和精神病性分）及治療后兩組PANSS總分及各因子分分別比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義。與治療前相比，治療后兩組PANSS總分[觀(guān)察組（47.94±13.64）分，對(duì)照組（49.07±12.56）分]及各因子分均顯著低于治療前PANSS總分[觀(guān)察組（86.31±9.21）分，對(duì)照組（85.95±9.77）分]及各因子分，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療前兩組患者糖、脂各指標(biāo)比較，差異無(wú)統(tǒng)計(jì)學(xué)意義。治療后對(duì)照組TG、TC、LDLC、BMI和腰圍上升，HDLC降低，與治療前比較，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀(guān)察組BMI和腰圍與治療前比較明顯變大，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀(guān)察組治療后TG、TC、LDLC、BMI和腰圍均顯著低于對(duì)照組，HDLC顯著高于對(duì)照組，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組FPG、2hPG、SBP和DBP比較，差異無(wú)統(tǒng)計(jì)學(xué)意義。觀(guān)察組患者不良反應(yīng)發(fā)生率明顯低于對(duì)照組（P<0.05）。結(jié)論 帕利哌酮緩釋片和利培酮對(duì)女性首發(fā)精神分裂癥患者具有相同的療效，但是帕利哌酮緩釋片對(duì)女性患者血脂、BMI和腰圍的影響較小，要優(yōu)于利培酮片。

Objective To compare the sustained-release tablets paliperidone and risperidone tablets starting glycolipid metabolism in female patients with schizophrenia. Methods Eighty-five cases of women treated in our hospital episode schizophrenia patients were randomly divided into observation group (42 cases) and control group (43 cases). were treated with sustained-release tablets paliperidone and risperidone tablets monotherapy two months. Measuring body mass index before and after treatment (BMI), waist circumference (waist), triglyceride (TG), high density lipoprotein (HDL), fasting plasma glucose (FPG), 2 h glucose after OGTT (2 h PG), Positive and Negative Syndrome scale (PANSS) for efficacy evaluation. Results Comparison minutes before treatment PANSS total score and factors, the difference was not statistically significant. After treatment, PANSS total score and factor scores, the difference was not statistically significant. Compared with the previous treatment, both groups PANSS total score and factor scores were significantly decreased after treatment, the difference was statistically significant (P<0.05). Two groups of patients before treatment indexes, the difference was not statistically significant. After treatment in the control group TG, former TC, HDLC, LDLC, BMI, and waist circumference with treatment, the difference was statistically significant (P<0.05); the observation group BMI and waist circumference compared with before treatment, the difference was statistically significant (P<0.05). After observation group TG, TC, LDLC, BMI and waist circumference were significantly lower than the control group, HDLC significantly higher, the difference was statistically significant (P<0.05). Two FPG, 2hPG, SBP and DBP, the difference was not statistically significant (P>0.05). Adverse reactions in patients in the observation group were significantly lower than the control group, the difference was statistically significant (P<0.05). Conclusion The sustained-release tablets paliperidone and risperidone female first-episode schizophrenia patients have the same effect, but paliperidone extended release tablets in female patients improve blood lipids, BMI and waist circumference is superior to risperidone.