DRD2、COMT多态性在抗精神病药致巨泌乳素血症中的意义  

Significance of DRD2 and COMT polymorphisms in macroprolactinemia induced by antipsychotics

作　　者：王振华[1] 金海英 费小聪[1] 雷礼磊 赵徐东 李建华[1] 陈海支[1] WANG Zhen-hua;JIN Haiying;FEI Xiaocong(Department of Psychiatry,Huzhou Third People's Hospital,Huzhou 313000,China)

机构地区：[1]湖州市第三人民医院精神科,浙江湖州313000

出　　处：《全科医学临床与教育》2022年第8期678-682,共5页Clinical Education of General Practice

基　　金：浙江省医药卫生科技项目临床研究应用项目(2022KY1225);浙江省医药卫生科技项目面上项目(2018KY786);浙江省湖州市科技局一般计划项目(2017GYB05)。

摘　　要：目的 探讨DRD2、COMT多态性在抗精神病药致巨泌乳素血症中的意义。方法 收集精神分裂症患者133例,治疗前泌乳素水平正常,予利培酮(4~6 mg/d)单药治疗,分别于基线和治疗第4周末采取外周静脉血,使用RFLP-PCR的方法分析DRD2 Taq1A、COMT Val158Met多态性,同时进行血清巨泌乳素、生化、甲状腺功能、生殖激素水平检测。通过泌乳素以及巨泌乳素水平分为高泌乳素血症组和巨泌乳素血症组,分析两组之间上述各指标的差异性。结果 两组之间DRD2 Taq1A和COMT Val158Met多态性不具有统计学差异(χ^(2)分别=0.54、5.94,P均>0.05);两组的C肽、雌二醇、胆固醇、胰岛素、TT3以及FT3水平存在明显差异(t分别=-2.16、-3.89、-2.54、-3.93、2.31、2.05,P均<0.05)。结论 DRD2 Taq1A和COMT Val158Met基因多态性可能还无法有效预测高泌乳素血症,但C肽、雌二醇、胆固醇、胰岛素、TT3以及FT3水平对高泌乳素血症和巨泌乳素血症的鉴别有一定的意义。Objective To investigate the significance of DRD2 and COMT polymorphisms in macroprolactinemia induced by antipsychotics. Methods Totally 133 patients with schizophrenia were collected,the prolactin levels of them were normal before the treatment,all of the patients were given risperidone(4~6 mg/d)monotherapy.Peripheral venous blood was taken befoe the treatment and at the end of the 4th week of the treatment.The polymorphisms of DRD2 Taq1A and COMT Val158Met were analyzed by RFLP-PCR,and the levels of serum macroprolactin,biochemistry,thyroid function and reproductive hormone were detected.Through the levels of prolactin and macroprolactin,they were divided into hyperprolactinemia group and macroprolactinemia group,the differences in the above indexes between the two groups were analyzed. Results There was no significant difference in DRD2 Taq1A and COMT Val158Met polymorphisms between the two groups(χ^(2)=0.54,5.94,P>0.05).But there were significant differences between the two groups in C peptide,estradiol,cholesterol,insulin,TT3 and FT3(t=-2.16,-3.89,-2.54,-3.93,2.31,2.05,P<0.05). Conclusion DRD2 Taq1A and COMT Val158Met gene polymorphisms may not be effective in predicting hyperprolactinemia,but the changes of Cpeptide,estradiol,cholesterol,insulin,TT3 and FT3 levels may have some suggestive significance for the differentiation of hyperprolactinemia and macroprolactinemia.

关 键 词：泌乳素 巨泌乳素 高泌乳素血症 精神分裂症 基因多态性 

分 类 号：R749.3[医药卫生—神经病学与精神病学]