抗精神病药与代谢综合征-培训课件.ppt

结论 二甲双胍与行为干预单用或合用均能有效和安全的减轻抗精神病药物引起的体重增加和胰岛素抵抗 二甲双胍与行为干预治疗合用减轻体重的疗效最好 二甲双胍与行为干预治疗缓解抗精神病药物引起的胰岛素抵抗的疗效相同 患者对二甲双胍治疗的依从性优于行为干预 Metabolic syndrome is a cluster of risk factors for cardiovascular disease. It comprises: i) central obesity defined by the increased waist circumference; ii) dyslipidemia, including elevated triglyceride and decreased high density lipoprotein cholesterol levels; iii) high blood pressure; and iv) elevated fasting plasma glucose levels. 该幻灯片展示了诊断系统中定义的每项代谢异常指标的临界值。可以看到，近来，两种诊断系统不仅给出了白种人的界值，而且有 针对不同种族的更为具体的临界值。例如像我们亚洲人，腰围的临界值比白种人少4-5英寸.。而且，两种系统的对于空腹血糖增高的临界值一致。管对于肥胖的标准要求不统一，但已经发现最新的ATP III 和 IDF诊断系统识别的相同的代谢综合征的个体，并需要相同的临床处理方法。因此，对于代谢综合征的研究和实践而言，两种诊断系统几乎相同。 This slide shows the cut points of each metabolic abnormalities defined by the diagnostic systems. It can be seen that, recently, both diagnostic systems give more specific cut points for ethnic groups other than Caucasians. For Asian people like you and I, the cut points for increased waist circumferences are about 4-5 inches shorter than the Caucasian ones. In addition, both systems have an agreement on the cut point of elevated fasting plasma glucose levels. Although there is a difference on the required criterion of obesity, it has been found that the updated ATP III and IDF diagnostic systems identify the same metabolic syndrome individuals and need identical clinical management. So, both systems are almost the same for metabolic syndrome research and practice. * 抗精神病物与代谢综合症 预防与干预的思考 中南大学湘雅二医院精神卫生研究所赵靖平 代谢综合症: 概念 包含下述心血管疾病(CVD)危险因素的群体: 向心性肥胖 (腰围?),体质量? 血脂异常 甘油三酯? 高密度脂蛋白（HDL-C）? 血压? 空腹血糖(FPG) ? 代谢综合症的标准 ATP III (2000) ATP IIIU (2004)1 IDF (2005)1 ? 腰围 M ≥40英寸, F ≥35 英寸 M ≥40 英寸 F ≥35 英寸白种人 M ≥35英寸, F ≥31英寸 美国亚裔 南亚/中国人 ? Tg ?150 mg/dL ?150 mg/dL 或正在接受药物治疗 ? HDL-C M 40 mg/dL / F 50mg/dL M 40 mg/dL / F 50mg/dL或正在接受药物治疗 ? BP ?130/?85 mm Hg ?130/?85 mm Hg或正在接受药物治疗 ? FPG ?110 mg/dL ?100 mg/dL或正在接受药物治疗 1identify the same MetS individuals and need identical clinica