加用阿立哌唑对利培酮所致精神分裂症男性患者高催乳素血症的影响  

Effect of aripiprazole on the hyperprolactinmia induced by risperidone in male schizophrenia patients

作　　者：陈海支[1] 钮富荣[1] 钱敏才[2] 俞柏润[1] 沈鑫华[2] 杨身国[2] 钟华[1] 黄卫权[3] 杨胜良[2] 沈仲夏[2] 

机构地区：[1]湖州市第三人民医院精神科,313000 [2]湖州市第三人民医院心身科,313000 [3]湖州市第三人民医院检验科,313000

出　　处：《中华精神科杂志》2009年第4期224-227,共4页Chinese Journal of Psychiatry

摘　　要：目的探讨加用阿立哌唑对利培酮所致的首次发病的男性精神分裂症患者高催乳素血症的影响及安全性。方法将80例男性精神分裂症首次发病住院患者随机分为研究组（40例）和对照组（40例）。使用利培酬治疗4周后催乳素水平≥60μg／L的患者，在维持原有治疗不变的基础上，研究组加用阿立哌唑5mg／d，对照组加用安慰剂治疗，总疗程12周，研究周期8周（第4～12周末）。于治疗第0，4，8，12周末检测血清催乳素含量，并用阳性和阴性症状评定量表（PANSS）、治疗中需要处理的小良反应量表（TESS）进行评定。结果研究组治疗第12周末血清催乳素[（25±7）μg/L]较第4周末[（76±17）μg/L]下降，差异有统计学意义（t=15．87；P〈0．01）。对照组治疗第12周末催乳素[（79±13）μg/L]与第4周末[（78±15）μg/L]比较，差异无统计学意义（t=0．72；P〉0．05）；治疗第12周末催乳素下降率为（66±11）％、正常率为67．6％，均高于对照组[分别为（-1±18）％、6．5％]（P均〈0．01）。两组患者治疗前后比较，PANSS评分总分及分量表分均明显下降（P均〈0．01）；在治疗第12周末两组之间各项评分比较，差异均无统计学意义（t=0．40，0．76，0．22，0．88；P均〉0．05）。治疗第12周末研究组TESS评分（4．8±4．3）与对照组（4．5±3．9）的差异无统计学意义（t=0．29；P〉0．05）。结论阿市哌唑治疗利培酮所致精神分裂症男性患者高催乳素血症有效，安全。Objective To investigate the efficacy and safety of aripiprazole on the hyperprolactinmia induced by risperidone in the first-episode patients with male schizophrenia. Methods All 80 first-episode male inpatients who had received no antipsychotic medication were randomly assigned to research group （n = 40） and control group （n = 40）. All the patients were treated with risperidone for 4 weeks, and then patients whose prolactin level reached to 60 μg/L were administered additional aripiprazole 5 mg daily or placebo for 12 weeks. The plasma prolactin （PRL） level was measured at weeks 0, 4, 8, 12, and the Positive and Negative Syndrome Scale （PANSS） and Treatment Emergent Symptom Scale （TESS） were assessed. Results Plasma prolactin levels were significantly reduced at the end of the study compared with the 4th weekend [ （25 ±7） μg/1, vs. （76 ± 17） μg/L] in research group （t = 15.87; P 〈0. 01 ）, while there were no significant difference between the 4th weekend and post treatment in control group [ （78 ± 15 ） μg/L vs. （79 ± 13）μg/L] （t = 0. 72; P 〉 0. 05 ）. At week 12, the decline rate and the normal ratio of plasma prolactin levels were significantly higher in aripiprazole group μ （66 ± 11 ）% , 67. 6% ] than that in control group [ （ -1 ± 18）%, 6. 5% ] （both P 〈0. 01）. Compared with the baseline, the PANSS score showed significant reduction in both groups at the end of the study [ （38.29 ± 5.67） vs. （83.68 ± 12. 56）],[（39.71 ±7.80） vs. （83.81 ± 13.47）] （both P 〈0.01）, and there were no significant differences on the PANSS score between both groups （P 〉 0. 05 ）. The incidence of side effects showed no significant difference between aripiprazole and control group （P 〉 0. 05 ）. Conclusion The results indicate that aripiprazole may be effective and safe for the treatment of male schizophrenics with risperidone induced hyperprolactinemia.

关 键 词：精神分裂症 高催乳素血症 利哌立酮 阿立哌唑 

分 类 号：R686[医药卫生—骨科学]