目的 观察对比帕利哌酮缓释片与利培酮片对女性首发精神分裂症患者糖脂代谢影响。方法 将85例在德阳市精神卫生中心治疗的女性首发精神分裂症患者随机分为观察组42例和对照组43例，分别给予帕利哌酮缓释片和利培酮片单药治疗2个月。治疗前后测量体质量指数（BMI）、腰围、三酰甘油（TG）、总胆固醇（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），采用阳性和阴性症状量表（PANSS）进行疗效评价。结果 治疗前两组PANSS总分及各因子分（阳性症状、阴性症状和精神病性分）及治疗后两组PANSS总分及各因子分分别比较，差异均无统计学意义。与治疗前相比，治疗后两组PANSS总分[观察组（47.94±13.64）分，对照组（49.07±12.56）分]及各因子分均显著低于治疗前PANSS总分[观察组（86.31±9.21）分，对照组（85.95±9.77）分]及各因子分，差异具有统计学意义（P<0.05）。治疗前两组患者糖、脂各指标比较，差异无统计学意义。治疗后对照组TG、TC、LDLC、BMI和腰围上升，HDLC降低，与治疗前比较，差异具有统计学意义（P<0.05）；观察组BMI和腰围与治疗前比较明显变大，差异具有统计学意义（P<0.05）。观察组治疗后TG、TC、LDLC、BMI和腰围均显著低于对照组，HDLC显著高于对照组，差异具有统计学意义（P<0.05）。两组FPG、2hPG、SBP和DBP比较，差异无统计学意义。观察组患者不良反应发生率明显低于对照组（P<0.05）。结论 帕利哌酮缓释片和利培酮对女性首发精神分裂症患者具有相同的疗效，但是帕利哌酮缓释片对女性患者血脂、BMI和腰围的影响较小，要优于利培酮片。

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.