氯氮平与利培酮对精神分裂症患者血清催乳素的影响  

The Influence of Clozapine and Risperidon on Seroprolactin in the Patients with Schizophreniac

作　　者：刘燕[1] 李华芳[2] 邓红玉[1] 王克勋[2] 高哲石[1] 顾牛范[2] 

机构地区：[1]上海市精神卫生中心分部,上海市201108 [2]上海市精神卫生中心,上海市200030

出　　处：《中国医院用药评价与分析》2003年第6期356-358,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的 :探讨氯氮平与利培酮对血清催乳素的影响及催乳素与药物疗效、体重、胰岛素抵抗之间的相互关系。方法 :64例停药 1月以上的精神分裂症患者分别服用氯氮平 (n =3 3 )与利培酮 (n =3 1) ,治疗前及治疗后 8周分别测定其空腹血清催乳素、瘦素、胰岛素、血糖水平 ,测身高与体重 ,以体重BMI(BMI =体重 身高2 (kg m2 ) )评定体脂情况 ,以胰岛素抵抗指数 (HOMA -InsulinResistance,HOMA -IR =空腹胰岛素×空腹血糖 )评定胰岛素抵抗 ,以BPRS减分率评定药物疗效。结果 :治疗 8周后利培酮组血清催乳素明显增加 (治疗前vs治疗后 :(651 2 8± 42 9 0 4)mIU Lvs(163 7 60± 10 60 3 5)mIU L ,P =0 0 0 0 ) ,而氯氮平组催乳素浓度无明显改变 (治疗前vs治疗后 :(43 0 57± 43 1 52 )mIU Lvs (3 72 11± 194 57)mIU L ,P =0 687)。多因素逐步回归显示催乳素与性别及不同药物有关。结论 :利培酮能增加血清催乳素水平 ,氯氮平对催乳素基本无影响 ,催乳素与药物疗效、体重。OBJECTIVE: To study the influence of clozapine and risperidon on ser oprolactin and the relationship between seroprolactin and drug efficiency , body weight and insulin resistance .METHODS : 64 cases with schizophreniac which sto pped taking drugs for more than 1 month were given clozapine (n=33) and rispe ridon (n=31) respectively .Their fasting seroprolactin, leptin, insulin, blood s uger lev el , body height and weight were measured 8 weeks before and after treatment . T o evaluate body lipid by BMI[BMI=weight/height 2 (kg/m 2)]; To evaluate insu lin resistance by insulin resistance index (HOMA-Insulin Resistance, HOMA-IR=fas ting insulin×fasting blood suger ); To evaluate drug efficiency by BPRS decreme nt .RESULTS : Seroprolactin of risperidon group obviously increased after treat ment for 8 weeks [before treatment vs after treatment (651 28±429 04) m IU/L vs (1 637 60±1 060 35) mIU/L, P=0 000],but seroprolact in of clozapine group had no obvious changes [before treatment vs after treatment :(430 57±431 52 ) mIU/L vs (372 11±194 57) mIU/L,P=0 687]. regression of mu ltiple factors showed that seroprolactin was associated with sex and different d rugs .CONCLUSION: risperidon can increase the level of seroprolactin, clozapine has little effect on seroprolactin. There is no direct correlation among seropro lactin, drug efficiency, weight,leptin and insulin resistance.

关 键 词：氯氮平 利培酮 精神分裂症 血清催乳素 体重 胰岛素抵抗 瘦素 临床研究 病例分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R971.41[医药卫生—临床医学]