棕榈酸帕利哌酮注射液治疗精神分裂症患者内分泌代谢的影响观察  

Effects on endocrine metabolism were observed in patients with schizophrenia receiving paliperidone palmitate

作　　者：陆敏[1] 班春霞[1] 李冠军[2] 高存友 李广伟[1] 程诚 李莉[1] 周耀明[1] 陈敬兰 孙仲礼 LU Min;BAN Chun-xia;LI Guan-jun;GAO Cun-you;LI Guang-wei;CHENG Cheng;LI Li;ZHOU Yao-ming;CHEN Jing-lan;SUN Zhong-li(Shanghai Jiading District Mental Health Center,Shanghai 201806,China)

机构地区：[1]上海市嘉定区精神卫生中心,201806 [2]上海市精神卫生中心

出　　处：《临床精神医学杂志》2024年第6期444-447,共4页Journal of Clinical Psychiatry

基　　金：上海市嘉定区卫生系统面上科研项目(2021-KY-13);上海市嘉定区卫生健康委员会公共卫生面上科研项目(2023-KY-27)。

摘　　要：目的:评估精神分裂症患者接受棕榈酸帕利哌酮注射液1个月剂型(once-monthly paliperidone palmitate,PP1M)治疗后内分泌、代谢情况。方法:对51例口服利培酮治疗有效的精神分裂症患者换用PP1M治疗后,于基线及治疗后1个月、3个月、6个月、12个月监测内分泌、代谢等相关指标,于基线及治疗后12个月对患者进行个体和社会功能量表(personal and social performance scale,PSP)评估。结果:治疗12个月时PSP因子分对社会有益的活动、扰乱及攻击行为两项与基线相比,差异具有统计学意义(t=-2.07、3.71,P均<0.05);重复测量方差分析显示,不同时间点,患者体质量指数、腰围、血糖、血脂等指标差异均无统计学意义(P>0.05);而在血清泌乳素(prolactin,PRL)上,差异具有统计学意义(F=3.021,P<0.05),且各个时间点血清泌乳素浓度均高于基线(P均<0.05)。结论:PP1M对代谢影响较小,且能改善患者社会功能,但会导致血清PRL水平增高,需引起关注。Objective:To evaluate the endocrine and metabolic conditions of patients with schizophrenia after treatment with once-monthly paliperidone palmitate(PP1M).Method:51 patients with schizophrenia who responded well to oral risperidone treatment were monitored for endocrine and metabolic related indicators at baseline and 1 month,3 months,6 months,and 12 months after switching to PP1M treatment for 1 year.The personal and social performance scale(PSP)was used to evaluate the individual and social function of the patients at baseline and 12 months after treatment.Results:After one year of PP1M treatment,there were significant differences in the PSP factor scores of beneficial activities to society and disruption and aggressive behavior compared to the baseline values(t=-2.07、3.71,all P<0.05).Repeated measures variance analysis showed that there were no significant differences in body mass index,waist circumference,blood sugar,and blood lipid levels at different time points(all P>0.05).However,there were significant differences in serum prolactin(PRL)concentration(F=3.021,all P<0.05),with serum PRL levels at each time point being higher than the baseline levels,and the differences were all significant(all P<0.05).Conclusion:Long-term use of PP1M for the treatment of schizophrenia has no significant impact on metabolism,but it can cause a significant increase in prolactin levels,and this needs attention.

关 键 词：棕榈酸帕利哌酮注射液(1个月剂型) 精神分裂症 代谢 内分泌 

分 类 号：R749.3[医药卫生—神经病学与精神病学]