阿立哌唑对抗精神病药致女性精神分裂症患者血浆泌乳素水平升高的影响

摘要

Objective:To explore the effect of aripiprazole on higher plasma prolactin(PRL)level caused antipsychotic drugs in female schizophrenic patients. Method:Sixty female schizophrenic patients with hyperprolactinemia(HPL)treated by risperidone,olanzapine,quetiapine,amisulpride,ziprasidone respec-tively were divided into the intervention group and the control group by random number table method;30 cases in each group.Besides the same antipsychotic drug kinds and dose,the patients in the intervention group were added aripiprazole 5 mg/d for 6 weeks.Before treatment and 2,6 weeks after treatment,the plasma PRL level of the two groups was detected,and positive and negative symptoms scale(PANSS)and treatment of symptoms scale(TESS)were administered respectively. Results:After 2,6 weeks of the treatment,the plasma PRL lev-el in the intervention group were significantly decreased than before treatment and in the control group were sig-nificantly increased(P<0.05 or P<0.01);the differences between the two groups were statistically significant (all P<0.05).After the end of the 6 weeks,the PANSS scores in the two groups were significantly decreased than before treatment,except the negative symptom score in the control group(P <0.05 or P <0.01).The score of negative symptoms in the intervention group was obviously lower than the control group(P<0.05). The extrapyramidal adverse reaction rate in the intervention group was obviously lower than the control group (P<0.05). Conclusion:Combintion with small dose of aripiprazole can improve HPL caused by second generation antipsychotic drugs,with efficacy and safety.%目的:探讨阿立哌唑对抗精神病药致女性精神分裂症患者泌乳素(PRL)升高的影响.方法:60例分别使用利培酮、奥氮平、喹硫平、氨磺必利、齐拉西酮治疗后出现高泌乳素血症(HPL)的女性精神分裂症患者按随机数字表法分为干预组和对照组,各30例;两组原抗精神病药物种类与剂量不变,在此基础上干预组合并阿立哌唑5 mg/d治疗6周;分别于治疗前和治疗第2、6周末检测血浆PRL水平,并给予阳性和阴性症状量表(PANSS)和治疗中出现的症状量表(TESS)评定. 结果:第2、6周末血浆PRL水平干预组较入组时明显下降,对照组明显升高(P<0.05或P<0.01);两组间差异有统计学意义(P<0.05);治疗第6周末,对照组除阴性症状评分外,两组PANSS各项评分及总分均较治疗前明显下降(P<0.05或P<0.01);干预组阴性症状评分组明显低于对照组(P<0.05);干预组锥体外系不良反应率明显低于对照组(P<0.05). 结论:合并小剂量阿立哌唑对临床常用二代抗精神病药物所致HPL具有改善作用,且更兼具疗效和安全性.