女性精神病患者服用抗精神病药物致高泌乳素血症的临床诊治效果  

Clinical Diagnosis and Treatment of Hyperprolactinemia Caused by Antipsychotic Drugs in Female Psychotic Patients

作　　者：白云洋 张婷婷 戴子琪 徐晶 韩静艳 BAI Yunyang;ZHANG Tingting;DAI Ziqi;XU Jing;HAN Jingyan(The Fourth People's Hospital of Liaoyang,Liaoyang 111000,China)

机构地区：[1]辽阳市第四人民医院,辽宁辽阳111000

出　　处：《中国医药指南》2021年第7期65-66,共2页Guide of China Medicine

摘　　要：目的探讨女性精神病患者服用抗精神病药物致高泌乳素血症的临床诊治效果。方法选取我院2017年1月至2020年1月接收的应用抗精神病药物治疗且导致高泌乳素血症的80例女性精神病患者,对照组40例泌乳素含量在30~100 ng/L范围内,观察组40例泌乳素含量在100~200 ng/L范围内。在上述80例患者中选择抗精神病药物应用前机体泌乳素水平在30 ng/L以下而应用药物后在100 ng/L的患者,共有40例,前者设为对照组1,后者设为观察组2。观察患者身体恢复情况。结果观察组异常子宫出血发生率、泌乳发生率明显高于对照组,组间差异有统计学意义(P<0.05);在所有患者中共有53例存在子宫出血症状(66.25%),其中慢性出血49例(92.45%)、急性出血4例(7.55%),44例(83.02%)患者需随访观察,10例患者选择药物治疗(18.87%),1例患者应用诊刮术治疗(1.89%);观察组1的促甲状腺激素明显高于对照组,游离甲状腺素明显低于对照组,组间差异有统计学意义(P<0.05);游离三碘甲状原氨酸对比无统计学意义(P>0.05)。结论女性精神病患者在应用抗精神病药物后较易出现高泌乳素血症,且机体中泌乳素含量越高越容易出现子宫异常出血与泌乳情况,泌乳素长时间在100 ng/L以下易导致促甲状腺激素升高、游离甲状腺素降低的情况。Objective To study the clinical diagnosis and treatment effect of hyperprolactinemia caused by antipsychotic drugs in female psychotic patients.Methods From January 2017 to January 2020,80 female patients with psychosis were selected in our hospital.All patients were treated with antipsychotics and had hyperprolactinemia.The prolactin content of 40 cases in the control group was in the range of 30-100 ng/L,and that of 40 cases in the observation group was in the range of 100-200 ng/L.In addition,among the 80 patients mentioned above,40 patients whose prolactin level was below 30 ng/L before the application of antipsychotics but below 100 ng/L after the application of antipsychotics were selected.The former was set as control group 1 and the latter as observation group 2.Observe the patient’s physical condition.Results The incidence of abnormal uterine bleeding and lactation in the observation group was significantly higher than that in the control group,and the comparison between the two groups was statistically significant(P<0.05);53 cases of all patients had uterine bleeding symptoms(66.25%),including 49 cases of chronic(92.45%),4 cases of acute(7.55%),44 cases of patients need follow-up observation(83.02%),10 cases of patients choose drug treatment(18.87%),One patient was treated with curettage(1.89%);the thyroid stimulating hormone of observation group 1 was significantly higher than that of control group,and the free thyroxine was significantly lower than that of control group,and the comparison between groups was statistically significant(P<0.05);the comparison of free triiodothyronine was not statistically significant(P>0.05).Conclusion Female psychiatric patients are more likely to have hyperprolactinemia after the application of antipsychotic drugs,and the higher the prolactin content in the body,the more likely to have abnormal uterine bleeding and lactation.Prolactin at 100 ng/L for a long time is likely to lead to the increase of thyrotropin and the decrease of free thyroxine.

关 键 词：精神病 女性 抗精神病药物 高泌乳素血症 

分 类 号：R749[医药卫生—神经病学与精神病学]