阿立哌唑与利培酮对血清催乳素水平的影响

A controlled study of effect on serum prolactin level between aripiprazole and risperidone

目的:比较阿立哌唑与利培酮对精神分裂症患者血清催乳素(PRL)的影响及其与临床疗效的关系。方法:选取70例精神分裂症患者,随机分为阿立哌唑组36例,利培酮组34例,分别给予阿立哌唑和利培酮治疗8周,在治疗前及治疗1、2、4、6、8周末采用阳性与阴性症状量表(PANSS)对两组进行评定。并于治疗前、中、后采用放射免疫法测查PRL水平。结果:两组PANSS减分率分别为阿立哌唑组(44.9±15.0)%、利培酮组(51.3±14.3)%,临床有效率分别为89.7%、92.1%,治疗前后阿立哌唑组PRL水平比较差异无显著性(P>0.05),利培酮组PRL明显增高(P<0.05)。阿立哌唑组治疗前后PRL水平的差值与PANSS减分率经相关分析差异有显著性(r=0.50,P<0.05),而利培酮组差异则无显著性(r=0.20,P>0.05)。出现月经紊乱或泌乳阿立哌唑组(1/14,7.1%)较利培酮组(7/18,38.9%)明显为少(χ2=4.23,P<0.05)。结论:2药对精神分裂症均有较好疗效,阿立哌唑与利培酮对PRL影响不同,与疗效关系不明显。

Objective：To compare the effect on serum prolactin （PRL） level and its relationship with clinical efficacy between aripiprazole and risperidone treatment in schizophrenia. Method： 70 patients with schizophrenia were randomly divided into aripiprazole group （ n= 36） and risperidone group （ n = 34） for 8 treatment weeks. The positive and negative syndrome scale （PANSS） was evaluated before and after treatment 1,2,4,6,8 weeks. The PRL level was measured by radioimmunoassay before, during and after treatment. Results： The reduction of total scores of PANSS and the rate of clinical response were （44.9 ±15.0） % and 89.7% in aripiprazole group, （51.3 ± 14.3） % and 92.1% in risperidone group, respectively. There was no significant difference in serum level of PRL before and after treatment in aripiprazole group. However, the serum level of PRL increased highly after risperidone treatment （ P 〈 0.05）. There was a significant relationship between the dispersion of serum PRL level and the reduction of total PANSS score in aripiprazole group between before and after treatment （ r = 0.50, P 〈 0.05 ）; however, not in risperidone group （ r = 0.20, P 〉 0.05）. Compared with patients in risperidone group （7/18,38.9%）, patients in aripiprazole group （1/14,7.1%） seldom had menstruation dysfunction and lactation （Χ^2 = 4.23, P 〈 0.05）. Conclusion： Aripipazole is as effective as risperidone in the treatment of patients with schizophrenia, with less influence on serum PRL level, which differentiate from risperidone and has no relationship with clinical efficacy.