首发精神分裂症患者治疗过程中血清催乳素水平动态观察

Observation of developments of the level of serum prolactin of first-episode schizophrenia patients during the treatment

目的:探讨首发精神分裂症患者用氯氮平与利培酮治疗过程中,血清催乳素(PRL)的变化及与临床疗效的关系。方法:选择符合诊断标准的首发精神分裂症患者54例,随机分为氯氮平组与利培酮组,治疗12周,采用阳性和阴性症状量表(PANSS)在治疗前后分别评定一次;用化学发光法在治疗前和治疗2、4、8、12周测定血清PRL浓度。结果:治疗前后两组在PANSS总分上无显著差异(t=0. 27,P>0. 05;t=0. 34,P>0. 05),治疗前患者与对照组血清PRL水平无显著差异(t=0. 61,P>0. 05),用氯氮平治疗后PRL水平变化不明显(t2W =0. 23,t4W=0. 47,t8W =0. 87, t12W =0. 67 ,P均>0. 05),用利培酮治疗后PRL水平显著升高(t2W =3. 12,t4W =4. 77,t8W =7. 58,t12W =7. 26 ,P均<0.01)。结论:氯氮平不引起明显的PRL升高, 而利培酮有较强的致PRL升高的作用。

Objective:To explore the relationship between the change of serum prolactin in first-episode schizophrenia patients during the treatment and clinical efficacy of clozapine and risperidone. Methods: Choose 54 standard first-episode schizophrenia patients. They were randomly divided into Clozapine group and Risperidone group. They were treated for 12 weeks. Adopting the Positive and Negative Symptoms Scale (PANSS) to separately assess them once before and after treatment. They were assessed serum concentration by chemical shining means before the treatment and during week 2, week 4, week 8 and week 12. Results: The two groups showed no remarkable difference in PANSS total (t=0.27, p>0.05; t=0.34, p>0.05). The patients before the treatment and those control group had no obvious difference in serum PRL level (t=0.61, p>0.05). The PRL level changed a little after the treatment of clozapine (t2w=0.23, t4w=0.47, t8w=0.87, t12w=0.67, all p>0.05). The PRL level rose obviously after the treatment of risperidone (t2w=3.12, t4w=4.77, t8w=7.58, t12w=7.26, all p<0.01). Conclusions: It is indicated that clozapine can't cause obvious rise of PRL while risperidone can raise PRL highly.