目的：探讨长期服用不同抗精神病药的精神分裂症患者对骨密度的影响。方法选取2010年1月~2011年12月北京市海淀区精神卫生防治院住院精神分裂症患者50例，依据对泌乳素影响不同，分为泌乳素升高药物组(28例，使用利培酮)和泌乳素抑制药物组(22例，使用奥氮平或喹硫平)，接受单一药物治疗，随访2年。主要测定患者桡骨骨密度。结果随访2年后，泌乳素升高药物组与泌乳素抑制药物组骨密度分别改变(-0.95±0.88)和(-0.27±1.47)，两组比较差异有统计学意义(P=0.048)。2例出现单侧股骨颈骨折的患者均在泌乳素升高药物组。结论长期服用引起高泌乳素血症的抗精神病药物，会造成骨密度流失更加严重，骨质疏松发生率更高，骨折的风险显著增加。%Objective To explore bone mineral density (BMD) changes over two years in patients with schizophrenia taking prolactin-raising antipsychotics. Methods From January 2010 to December 2011, 50 inpatients with schizophre-nia enrolled from Haidian Mental Health Hospital of Beijing City were divided into prolactin-raising group (given risperidone, 28 cases) and prolactin-sparing group (given olanzapine or quetiapine, 22 cases). The BMD of radial bones were measured. Results After two years, the BMD alterations were (-0.95±0.88) and (-0.27±1.47) in prolactin-raising group and prolactin-sparing group, the difference was statistically significant (P= 0.048). And hip fractures were oc-curred in 2 patients of prolactin-raising group. Conclusion In patients with schizophrenia taking long term prolactin-raising antipsychotics, bone loss are more severe, and the rates of osteoporosis and hip fracture are higher.
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