长期住院男性精神分裂症患者甲状腺激素和性激素水平及其影响因素

摘要

目的 探讨长期住院男性慢性精神分裂症患者血清甲状腺激素以及性激素水平及其影响因素.方法 选取长期住院男性精神分裂症的单一用药者,氯丙嗪组51例,氯氮平组67例,作为研究组,健康对照组60例,于同一时间检测甲状腺激素以及性激素水平,并分析研究组激素水平与病程、服药时长、症状等的相关性.结果 氯丙嗪组首发年龄、服药剂量(均折合为氯丙嗪量)均高于氯氮平组(P＜0.01).三组FT4、T3、PRL、E2水平比较差异有统计学意义(P＜0.01).进一步两两比较发现,氯丙嗪组和氯氮平组FT4、T3、PRL水平高于对照组(P＜0.01),E2水平低于对照组(P＜0.01);氯丙嗪组的PRL水平高于氯氮平组和对照组(P＜0.01).患者FT3与PANSS总分及阴性症状分、一般病理分呈负相关(P＜0.05),FT4与年龄呈正相关(P＜0.05),T3与PANSS阴性量表分呈负相关(P＜0.05). E2与PANSS总分及阳性症状分呈正相关(P＜0.05).结论 长期住院经单一用药治疗的精神分裂症患者(氯丙嗪、氯氮平)的甲状腺功能紊乱,PRL水平明显升高,氯丙嗪对PRL的影响高于氯氮平,低E2水平可能是精神分裂症的属性标志.%Objective To explore the serum thyroid hormone and sex hormone levels in patients with chronic schizophrenia , as well as its influencing factors.Methods Select long-term hospitalized single-drug patients, 51 patients in the chlorpromazine group and 67 patients in the clozapine groupas the study group , and select 60 cases as healthy control group.Detect thyroid hormones and sex hormone levels at the same time , and analysize the relevanceof hormone levels and disease duration , medication duration, symptoms, etc.in study group.Results The chlorpromazine group's initial age of onset and dose (both equal to chlorpromazine) were higher than the clozapine group (P＜0.01).There was statistical significance in the levels of FT4, T3, PRL and E2between the three groups (P＜0.01).After further comparisons, the levels of FT4, T3, and PRL in the chlorpromazine group and clozapine group were higher than those in the control group (P＜0.01), and E2levels were lower in the control group (P＜0.01); The PRL in the chlorpromazine group was higher than that in the clozapine group and the control group (P＜0.01).There was a negative correlation between FT 3and PANSS total scores and negative symptom score and side pathological score (P＜0.05).FT4was positively correlated with age (P＜0.05).T3was negatively correlated with PANSS negative scales (P＜0.05).There was a positive correlation between E2and PANSS scores and positive symptoms (P＜0.05). Conclusion Long-term hospitalized patients with schizophrenia ( chlorpromazine, clozapine) treated with a single medication had thyroid dysfunction , and PRL levels were significantly elevated.Chlorpromazine had a greater effect on PRL than clozapine. The low level of E2may be attributed symbol of schizophrenia.