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目的：探讨托吡酯对奥氮平所致精神分裂症患者体质量增加及血浆瘦素水平的影响。方法将72例首发精神分裂症患者按随机数字表法分为两组，每组36例，两组均口服奥氮平治疗，研究组联合托吡酯治疗，观察6周。治疗前后采用阳性与阴性症状量表评定精神症状，检测体质量及血浆瘦素水平的变化。结果治疗后两组阳性与阴性症状量表评分均较治疗前显著下降（P＜0．01），研究组治疗第6周末阳性与阴性症状量表评分显著低于对照组（P＜0．01）。研究组治疗前后体质量无显著变化（P＞0．05）；对照组治疗后体质量较治疗前显著增加（P＜0．01），且显著高于研究组（P＜0．01）。治疗后两组血浆瘦素水平均较治疗前显著升高（P＜0．01），同期两组间比较差异均无显著性（P＞0．05）。结论托吡酯能有效地抑制奥氮平治疗精神分裂症导致的体质量增加反应，且具有协同增效作用趋势，但对患者的血浆瘦素水平无明显影响。“,”Objective To explore the effects of topiramate on olanzapine‐induced weight gain and plasma leptin levels of schizophrenics .Methods Seventy‐two first‐episode schizophrenics were randomly divided into two groups of 36 ones each ,both groups took orally olanzapine ,and research group was plus topiramate for 6 weeks .Mental symptoms were assessed the Positive and Negative Syn‐drome Scale (PANSS) before and after treatment ,changes of body mass and plasma leptin levels detected . Results After treatment the PANSS scores of both groups lowered more significantly compared with pre‐treatment (P<0 .01) ,that was significantly lower in research than control group at the ends of the 6th week (P0 .05);body mass increased more significantly after treatment compared with pretreat‐ment in control group (P<0 .01) and was significantly higher than in research (P<0 .01) .After treat‐ment plasma leptin levels of both groups heightened more significantly compared with pretreatment (P0 .05) .Conclusion Topiramate can effectively pre‐vent olanzapine‐induced weight gain of schizophrenics ,has a synergism tendency ,but has no significant in‐fluence on plasma leptin levels .