不同剂量阿立哌唑对氨磺必利和利培酮引起的高催乳素血症的影响  

Effect of various doses aripiprazole on hyperprolactinemia induced by amisulpride and risperidone

作　　者：徐彩霞[1] 黄炜[1] 赵惜辉[1] 梁震韬[1] 邓文[1] 

机构地区：[1]广东省佛山市第三人民医院精神科,528041

出　　处：《中华精神科杂志》2015年第5期297-302,共6页Chinese Journal of Psychiatry

基　　金：佛山市医学类科技攻关项目（201008062）

摘　　要：目的 探讨不同剂量阿立哌唑治疗氨磺必利和利培酮所致高催乳素血症的疗效及安全性.方法 采用随机数字表法将87例氨磺必利所致高催乳素血症患者随机分为氨磺必利联用5、10、15 mg阿立哌唑（Ami＋5 mg、Ami＋10 mg、Ami＋15 mg）组,每组29例;将106例利培酮所致高催乳素血症患者随机分为利培酮联用5、10、15 mg阿立哌唑（Ris＋5 mg、Ris＋10 mg、Ris＋15 mg）组,每组分别为36例、35例、35例.维持原有氨磺必利或利培酮剂量不变,联用相应剂量阿立哌唑进行12周对照研究.于治疗前、治疗后第4周、第8周及第12周检测患者催乳素水平,观察高催乳素血症患者的相关临床变化;以PANSS和治疗中需处理的不良反应症状量表评定联用不同剂量阿立哌唑对疗效和不良反应的影响.结果 在第4、8、12周末氨磺必利合并阿立哌唑不同剂量组催乳素水平在组内及组间差异无统计学意义.利培酮合并阿立哌唑不同剂量组在第4周起催乳素水平均有显著下降并持续到12周,与基线时相比,Ris＋5 mg组[（38.9±19.0） nmol/L与（11.0±8.1） nmol/L]、Ris＋ 10 mg组[（36.2±16.5）nmol/L与（8.8±7.3）nmol/L]、Ris＋15 mg组[（35.6±14.8） nmol/L与（9.2±7.6）nmol/L]第12周催乳素水平差异有统计学意义（t=4.129、4.798、4.506,均P＜0.01）.Ris＋5 mg组、Ris＋10 mg组、Ris＋15 mg组高催乳素血症相关临床症状消失比率分别为66.67％（24/36）、62.86％ （22/35）、51.43％（18/35）,3组间高催乳素血症相关临床症状消失比率的差异无统计学意义.PANSS评分第12周末除Ami＋15 mg组、Ris＋10mg组、Ris＋15 mg组较基线有明显下降外（t=2.419、2.406、2.631,均P＜0.05）,其余差异均无统计学意义.Ami＋ 15 mg组不良反应率[52％（15/29）]高于Ami＋5 mg组[17％（5/29）,t=3.521,P＜0.01]和Ami＋10mg组[24％ （7/290）,t=2.348,P＜0.05],Ris＋ 15 mg组不良反应率[34％（12/35）]高于Ris＋5 mg组[11�Objective To investigate the efficacy and safety of different doses of aripirazole on hyperlactinemia induced by amisulpride and risperidone.Methods 87 patients with hyperlactinemia induced by amisulpride were randomly assigned to three groups on the basis of original medication combined with aripiprazole 5 mg/d,10 mg/d and 15 mg/d （Ami＋5 mg,Ami＋10 mg,Ami＋15 mg） with 29 cases in each group.106 patients with hyperlactinemia induced by risperidone were randomly assigned to three groups on the basis of original medication combined with aripiprazole 5 mg/d （36 cases）,10 mg/d （35 cases） and 15 mg/d （35 cases）.The plasma prolactin （PRL） level was measured before and after 4th,8th and 12th week treatment.The Positive and Negative Syndrome Scale （PANSS） and Treatment Emergent Symptom Scale （TESS） were assessed for psychotic symptoms and adverse effects.Results The level of PRL of Ami＋5 mg,Ami＋ 10 mg and Ami＋ 15 mg group had no statistical difference within and between groups at 4th,8th and 12th week.The level of PRL of Ris＋5 mg,Ris＋ 10 mg and Ris＋ 15 mg group were significantly lower than that of baseline at each visit after baseline.The level of PRL of Ris＋ 5 mg group （（38.9± 19.0） nmol/L vs.（11.0±8.1） nmol/L）,Ris＋ 10 mg group （（36.2± 16.5） nmol/L vs.（8.8±7.3） nmol/L） and Ris＋ 15 mg group（（35.6± 14.8） nmol/L vs.（9.2±7.6） nmol/L） at baseline were significantly different from which at the 12th week （t=4.129,4.798,4.506;all P〈0.01）.The remission rates of symptoms relevant with hyperlactinemia in Ris＋5 mg group,Ris＋10 mg group and Ris＋15 mg group were 66.67% （24/36）,62.86% （22/35）,51.43% （18/35） respectively.There were no difference of the remission rate of symptoms relevant with hyperlactinemia among those three groups.There were no difference of PANSS score within groups at 12th week except Ami＋ 15 mg group,Ris＋ 10 mg group and Ris＋ 15 mg group（t=2.419,2.406,2.631,all P〈0.05）.The adverse effect

关 键 词：高催乳素血症 精神分裂症 氨磺必利 利培酮 阿立哌唑 

分 类 号：R749.3[医药卫生—神经病学与精神病学]