阿立哌唑、齐拉西酮与利培酮对女性精神分裂症患者雌二醇水平的影响

摘要

目的：探讨利培酮、阿立哌唑与齐拉西酮对女性精神分裂症患者血清雌二醇水平影响及意义。方法180例女性精神分裂症患者随机分为利培酮组、阿立哌唑组和齐拉西酮组，每组各60例，疗程6个月，于治疗前及治疗后第1、3、6个月末评定阳性和阴性综合征量表（PANSS），并检测血清雌二醇水平。另检测30例健康对照者（对照组）的血清雌二醇水平比较。结果利培酮组、阿立哌唑组和齐拉西酮组治疗后各时点 PANSS 评分与同组治疗前比较均下降（P ＜0．01），同时点组间比较均无显著性差异（P ＞0．05）。三组治疗前血清雌二醇水平均低于对照组（P ＜0．01）；利培酮组治疗后各时点血清雌二醇水平低于治疗前（P ＝0．000），且均低于其他三组（P <0．01）；阿立哌唑组、齐拉西酮组治疗后各时点雌二醇水平逐渐升高（P ＜0．01），但与对照组比较均无显著性差异（P ＞0．05）。结论阿立哌唑、齐拉西酮与利培酮治疗女性精神分裂症患者疗效相当，但阿立哌唑和齐拉西酮能改善女性精神分裂症患者的雌二醇水平。%Objective To evaluate the effects of aripiprazole,ziprasidone and risperidone on serum level of estradiol in female patients with schizophrenia.Methods 180 female schizophrenic patients were randomized into aripiprazole group (60 cases),ziprasidone group (60 cases)and risperidone group (60 cases)treated with aripiprazole,ziprasidone and risperidone respectively for 6 months.All patients were assessed with Positive and Negative Syndrome Scale (PANSS)and were measured to detect the serum level of estradiol at the baseline and at the end of the 1 st ,3 rd and 6 th month of the treatment.The serum level of estradiol was measured in additional 30 healthy controls (control group).Results Intragroup comparison showed that total score of PANSS in aripiprazole group,ziprasidone group and risperidone group decreased significantly at each interview-point when compared with the baseline (P <0.01).No significant difference was found in total score of PANSS in intergroup comparison at each interview-point (P >0.05).The pre-treatment serum level of estradiol in three treatment groups was significantly lower than that in control group (P <0.01 ).Serum level of estradiol in risperidone group at each post-treatment interview-point was significantly lower than that at baseline (P =0.000)and was significantly lower than that in other three groups at each corresponding interview-point (P <0.01 ).Level of estradiol at each post-treatment interview-point in aripiprazole group and ziprasidone group increased gradually when compared with respective baseline (P <0.01 ),but no significant difference was found when compared with level of estradiol in control group (P >0.05 ).Conclusion Aripiprazole,ziprasidone and risperidone have equivalent efficacy on schizophrenia in females.Aripiprazole and ziprasidone can improve the lower serum level of estradiols in female schizophrenic patients.