氯丙嗪、利培酮、奎硫平及奥氮平引起男性精神分裂症患者性功能障碍特点及与血糖、血脂改变的关联  

Characteristics of the sexual disturbance caused by chlorpromazine, risperidone, quetiapine and olanzapine and their associations with the changes of blood glucose and blood lipids in male patients with schizophrenia

作　　者：曹栋[1] 谢世平[1] 陈启豹[1] 袁勇贵[1] 方群[1] 

机构地区：[1]南京医科大学附属脑科医院,江苏省南京市210029

出　　处：《中国临床康复》2005年第36期63-68,共6页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:对比观察氯丙嗪、利培酮、奎硫平、奥氮平引起的男性精神分裂症患者性功能障碍及其与血糖、血脂变化关联的可能性。方法:选择2003-10/2004-10在南京医科大学附属脑科医院住院的精神分裂症患者100例,随机分为氯丙嗪组、利培酮组、奎硫平组、奥氮平组,每组25例,各组患者在年龄、文化程度、病程、经济状况、夫妻关系及基线阳性与阴性症状量表评分等方面基线值均无显著性差异。患者法定监护人知情同意。氯丙嗪组、利培酮组、奎硫平组及奥氮平组分别予以氯丙嗪(25mg/片)、利培酮(1mg/片)、喹硫平(200mg/片)、奥氮平(5mg/片)进行干预。应用酶比色法、直接法、免疫比浊法分别测定各组患者治疗前、治疗后4,8周血糖、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A、载脂蛋白B水平。治疗前由配偶提供患者基线性功能资料,待患者精神症状缓解后可进一步完善评估。治疗4周后,精神分裂症患者的精神状态基本缓解,治疗8周后其精神状态基本康复,能独立完成问卷调查。利用自制男性性功能量表评估治疗前、治疗后8,12及16周的性功能量表状况(量表分为性欲、性唤起、性高潮及性满意度四项因子分,性功能总体因子分为上述四项分值总和)。结果:进入结果分析氯丙嗪组、利培酮组、奎硫平组、奥氮平组分别为17,19,19及18例。①性欲减退发生率:奎硫平在入组8周后显著低于氯丙嗪组、利培酮组[21.1%,58.8%,63.2%,(F=5.386,6.909,P<0.05)]。②性唤起困难发生率:奎硫平组在入组后的8,12及16周显著低于氯丙嗪组[(21.1%,21.1%,15.8%),(64.7%,70.6%,70.6%),(F=7.034,6.916,11.9,P<0.05)]。又显著低于利培酮组[(63.2%,47.4%,57.9%),(F=6.909,2.923,7.238,P<0.05)]。③血糖水平:氯丙嗪组治疗8周后显著高于基线值(F=7.224,P<0.01);奥氮平组在治疗8周后显著高于基线值(F=3.187,P=0.05);利培酮组AIM：To observe the sexual disturbance in male patients with schizophrenia caused hy chlorpromazine, risperidone, quetiapine and olanzapine and their associations with the changes of blood glucose and blood lipids. METHODS：Totally 100 male inpatients with schizophrenia in the Brain Hospital affiliated to Nanjing Medical University between October 2003 and October 2004 were randomly divided into chlorpromazine group （n=25）, risperidone group （n= 25）,quetiapine group（n=25）artd olanzapine group （n=25）.There were insignificant differences in age,educational background,disease course, economic status, couples＇relationship and the baseline scores of positive and negative syndrome scale （PA NSS）, The patients in the four groups were treated with chlorpromazine （25mg/tablet）, risperidone （lmg/tablet）, quetiapine （200mg/tablet） and olanzapine （5 mgtablet） respectively. The levels of blood glucose, triaglyceride, high density lipoprotein cholesterol （HDL-C）,low density lipoprotein cholestero （LDL-C）,apolipoprotein A and apolipoprotein B were detected with enzyme chromatometry,direct method and immunoturbidimetry before treatment and 4 and 8 weeks after treatment. The baseline data of sexual function of the patients were provided by their spouses before treatment,and they were further evaluated after their psychiatric symptoms were relieved. The mental status of the patients with schizophrenia were generally relieved after 4 weeks, and rehabilitated ＂after 8 weeks,and they could finished the questionnaire inventory independently. The sexual function of the patients were assessed with the self-designed male sexual function scale before treatment and 8,12 and 16 weeks after treatment, the scale included4factorscoresofsexuality, sexualarousal, sexual orgasm and sexual satisfactory degree ,and the general fac tot score of sexual function w as the sum up of the 4 factor scores. RESULTS： There were 17, 19, 19 and 18 cases in the chlorpromazine group, risperidone group,quetiapin

关 键 词：氯丙嗪 精神分裂症 性功能障碍 血糖 

分 类 号：R749.3[医药卫生—神经病学与精神病学]