利培酮的内分泌副作用对女性患者情绪及生活质量的影响  

Effects of the endocrine side effects caused by risperidone on the emotion and life quality of female patients with schizophrenia

作　　者：于靖[1] 翁永振[1] 王传跃[1] 翟屹民[2] 刘瑞玫[2] 陈学红[3] 林守清[4] 

机构地区：[1]首都医科大学附属北京安定医院二科,北京市100088 [2]首都医科大学附属北京安定医院科研室,北京市100088 [3]首都医科大学附属北京安定医院功能检验科,北京市100088 [4]中国医学科学院中国协和医科大学北京协和医院妇科,北京市100730

出　　处：《中国临床康复》2004年第15期2836-2838,共3页Chinese Journal of Clinical Rehabilitation

基　　金：北京卫生扶持学科基金资助项目犤(1999)卫科扶字10号犦;首都医学发展科研基金资助项目(ZD199816)~~

摘　　要：目的:探讨女性精神分裂症患者利培酮治疗后神经内分泌副作用对情绪及生活质量的影响。方法:利培酮治疗的女性患者(18～43岁)58例,首次抗精神病药治疗前月经规律,利培酮单一治疗至少6个月,测血清催乳素、皮质醇、雌二醇、睾酮、促甲状腺素水平及基础体温,进行简明精神病量表(BPRS)、汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)评定及生活质量综合评定问卷(GQOLI-74)。结果:利培酮治疗后58例中,14例月经规律,23例月经不规律,21例闭经。44例有溢乳。研究组53例雌二醇≤50.0ng/L。研究组催乳素(中位数98.0μg/L)水平显著高于对照组(中位数9.3μg/L),差异有显著性意义(U=17.0,P<0.01);睾酮水平(μg/L)研究组(1.1±0.4)显著高于对照组(0.5±0.3)差异有显著性意义(t=7.32,P<0.01)。两组间皮质醇、促甲状腺素水平差异无显著性意义(P>0.05)。按月经情况分组比较,月经规律组、不规律组与闭经组3组间HAMD量表的绝望感因子分差异有显著性意义(F=3.71,P<0.05)。3组GQOLI-74的睡眠与精力因子分差异有显著性意义(F=3.968,P<0.05)。spearman相关分析显示,各激素水平与各临床量表的焦虑,抑郁因子间均无显著关(r=-0.132～0.258,P>0.05)。结论:利培酮治疗后出现的内分泌副作用可能对患者情绪、生活质量有不良影响。AIM:To explore the effects of the neuroendocrinologic side effects caused by r isperidone on the emotion and life quality of schizophrenic women. METHODS:Fifty-eight female schizophrenic patients,aged 18-43 years old,with normal menstrual cycle before the initial treatment of antipsychotics,were invol ved in the cross-sectional study.After treated with risperidone alone for at le ast 6 months,the levels of prolactin,cortisol,estradiol,testosteone and thyroid stimulating hormone of serum as well as the basic body temperature were measured .The Brief Psychiatric Rating Scale(BPRS),Hamilton Anxiety Scale(HAMA),Hamilton Rating Scale for Depression(HAMD) and Generic Quality of Life Inventory-74(GQOL I-74) were examined. RESULTS:In the 58 patients,14 were with regular menstrual cycle,23 with irregu lar menstrual cycle and 21 with amenorrhea,44 of them were suffering from galact orrhea and 53 of them with estradiol≤50.0 ng/L.The serum prolactin level in the study group(median 98.0 μg/L) was significantly higher than that in the contro l group(median 9.3 μg/L)(U=17.0,P< 0.01).The testosteone level in the study gro up[(1.1±0.4) μg/L] was significantly higher than that in the control group[(0. 5±0.3) μg/L](t=7.32, P< 0.01).There were no significant differences in cortiso l and thyroid stimulating hormone levels between the two groups(P >0.05). There was a significant difference in the despair factor of HAMD(F=3.71,P< 0.05) and t he factor of sleep and energy of the GQOLI-74 among the groups with regular men ses,irregular menses and amerorrhea(F=3.968,P< 0.05).The spearman correlation an alysis showed that there was no significant relation between the levels of hormo nes and anxious and depressive factors of the scales(r=-0.132-0.258,P >0.05). CONCLUSION:The endocrine side effects caused by risperidone may have negative effects on the emotion and life quality of female patients with schizophrenia.

关 键 词：利培酮 副作用 女性 情绪 生活质量 精神分裂症 抗精神病药 神经内分泌 

分 类 号：R971.4[医药卫生—药品]