阿立哌唑治疗利培酮所致男性精神分裂症患者泌乳素升高的疗效分析  

Effect of aripiprazole for risperidone-induced increased prolactin level in male schizophreniapatients

作　　者：黄楠[1] 苏亮[1] 江学锋[1] 赵翠 陆峥[1,3] Huang Nan;Su Liang;Jiang Xuefeng;Zhao Cui;Lu Zheng(Department of Psychiatry,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Department of Psychiatry,the Second People's Hospital of Honghe Hani and Yi Autonomous Prefecture,Honghe 654399,China;Department of Psychiatry,Tongji Hospital,Tongji University,Shanghai 200065,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心普通精神科,200030 [2]云南省红河哈尼族彝族自治州第二人民医院普通精神科,654399 [3]上海市同济大学附属同济医院精神医学科,200065

出　　处：《神经疾病与精神卫生》2019年第3期240-243,共4页Journal of Neuroscience and Mental Health

基　　金：国家重点研发计划(2016YFC1306805);国家自然科学基金(81471359);上海市重中之重临床医学中心和重点学科建设计划(2017ZZ02020);上海申康医院发展中心临床创新三年行动计划(16CR1032B);上海市精神卫生中心院级课题(2017-YJ-17).

摘　　要：目的探讨阿立哌唑治疗利培酮所致男性精神分裂症患者泌乳素升高的疗效及安全性。方法60例患者使用利培酮治疗4周末随机分配为研究组(利培酮+阿立哌唑)和对照组(利培酮)各30例,观察至8周末。在基线、第4周末、第8周末监测两组患者的泌乳素(PRL)水平,并进行阳性与阴性症状量表(PANSS)和UKU不良反应量表评估。结果使用利培酮治疗4周末,两组患者PRL水平均显著升高(P<0.01)。第8周末研究组PRL水平与自身相比显著降低(P<0.01),且与对照组比较差异有统计学意义(P<0.01);两组患者PANSS评分均较前显著降低(P<0.01),但两组间PANSS评分差异无统计学意义。两组均多见的不良反应有男性乳房发育、乏力、思睡、静坐不能、肌张力障碍、震颤,但上述不良反应发生率组间比较差异均无统计学意义(P>0.05)。结论利培酮可导致男性精神分裂症患者PRL增加,合并使用阿立哌唑可显著降低利培酮所致的男性精神分裂症患者PRL增高,但未增加不良反应发生率。Objectives To explore the effect and safety of aripiprazole for risperidone-induced increased prolactin level in male schizophrenia patients.Methods After using risperidone for 4 weeks,a total of 60 patients were randomized to study group(risperidone combined with aripiprazole,n=30) and control group(risperidone,n=30),and then receive treatment until the end of the 8th week.Serum prolactin levels were measured at baseline,the end of the 4th week and the 8thweek.Positive and Negative Syndrome Scale (PANSS) and Udvalg for Kliniske Undersogelser(UKU) side effect rating scale were assessed at baseline,the end of the 4th week and the 8th week.Results After 4 weeks' risperidone treatment,the PRL level of both groups increased significantly(P<0.01).At the end of the 8th week,PRL level of study group was significantly reduced than it at the 4th week(P<0.01),and the difference from control group was statistically significant(P< 0.01).The PANSS score of both groups decreased significantly(P< 0.01),however there was no statistically significance between two groups.The most common adverse reactions in the two groups were breast development in male,fatigue,sleepiness,sedentary dysfunction,dystonia and tremor,but there was no significant difference in the incidence of these adverse reactions between the two groups(P>0.05).Conclusions Risperidone can lead to increasing PRL level of male schizophrenia patients and aripiprazole combined treatment is effective and safe for risperidone-induced hyperprolactinemia,without increase of the incidence of side effects.

关 键 词：精神分裂症 阿立哌唑 利培酮 泌乳素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]