精神分裂症患者使用氨磺必利致高泌乳素血症后换药情况及对疾病复发的影响  

Medication switch after hyperprolactinemia induced by amisulpride in patients with schizophrenia and its impact on disease recurrence

作　　者：雷金兰 李阳 王莹 Lei Jinlan;Li Yang;Wang Ying(Department of Pharmacy,Lishui Second People′s Hospital,Lishui,Zhejiang 323000,China;Department of Psychiatry,Lishui Second People′s Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市第二人民医院药剂科,浙江丽水323000 [2]丽水市第二人民医院精神科,浙江丽水323000

出　　处：《中国药物与临床》2025年第3期169-173,共5页Chinese Remedies & Clinics

基　　金：浙江省丽水市科技计划项目(2023SJZC037)。

摘　　要：目的分析精神分裂症患者使用氨磺必利致高泌乳素血症后换药情况及对疾病复发的影响。方法选取浙江省丽水市第二人民医院2019年1月至2023年12月使用氨磺必利致高泌乳素血症的精神分裂症患者173例。收集基线临床资料、换药情况以及换药后6个月疾病复发情况,记录换用不同药物后不良反应以及血清催乳素水平变化。按照疾病是否复发分为复发组62例与非复发组111例,比较2组临床资料的差异,采用多因素Logistic回归模型进一步分析精神分裂症患者使用氨磺必利致高泌乳素血症换药后疾病复发的影响因素。结果使用氨磺必利致高泌乳素血症后将药物更换为阿立哌唑的患者有70例,更换为布南色林的患者57例,更换为奥氮平的患者46例。换用不同药物后3个月血清催乳素水平均降低,差异有统计学意义(P<0.05)。复发组在氨磺必利用药剂量、换药前疾病稳定时间、应激生活事件、阳性和阴性症状量表(PANSS)评分以及更换药物方面与非复发组比较,差异均有统计学意义(P<0.05)。多因素Logistic回归模型进一步分析结果发现,应激生活事件、PANSS评分以及所更换药物为阿立哌唑是精神分裂症患者使用氨磺必利致高泌乳素血症换药后疾病复发的独立危险因素(P<0.05),换药前疾病稳定时间、所更换药物为布南色林以及奥氮平是保护因素(P<0.05)。结论精神分裂症患者使用氨磺必利致高泌乳素血症后换药有助于降低血清催乳素水平,而且将药物更换为布南色林或奥氮平可能是预防疾病复发的最理想选择。Objective To analysis the medication switch after hyperprolactinemia induced by amisulpride in patients with schizophrenia and its impact on disease recurrence.Methods The study selected 173 cases of schizophrenia patients who developed hyperprolactinemia as a result of amisulpride usage at Lishui Second People′s Hospital from January 2019 to December 2023.Clinical data at baseline,dressing changes,and disease recurrence at 6 months after dressing changes were collected;The adverse reactions and changes in serum prolactin levels after switching to different drugs were recorded.All patients were divided into a disease recurrence group(62 cases)and a non-disease recurrence group(111 cases)based on whether the disease had recurred.The differences in clinical data between the two groups were compared,and a multivariate logistic regression model was used to further analyze the influencing factors of disease recurrence in schizophrenia patients with hyperprolactinemia induced by amisulpride after dressing change.Results There were 70 patients who switched to aripiprazole after hyperpro-lactinemia caused by amisulpride,57 patients who switched to budesonide,and 46 patients who switched to olanzapine.After switching to different drugs,the serum prolactin levels significantly decreased at 3 months,and the difference was statistically significant(P<0.05).The recurrence group was compared with the non-recurrence group in terms of the dosage of amisulpride,duration of disease stability before dressing change,stressful life events,PANSS score,and medication name change,the differences were statistically significant(P<0.05).Further analysis of the results,utilizing a multiple logistic regression model,revealed that stressful life events,PANSS scores,and switching medication to aripiprazole were independent risk factors for disease recurrence in schizophrenia patients experiencing hyperprolactinemia induced by amisulpride(P<0.05),the duration of disease stabilization prior to medication change,as well as switching medication

关 键 词：氨磺必利 精神分裂症 高泌乳素血症 复发 

分 类 号：R749.3[医药卫生—神经病学与精神病学]