奎硫平与利醅酮对精神分裂症患者血清催乳素水平的影响

The influence of quetiapine and risperidon on seroprolactin in the patients with schizophrenic

目的探讨奎硫平与利培酮对血清催乳素的影响及催乳素与药物疗效、体质量、胰岛素抵抗之间的相互关系。方法64例停药1月以上的精神分裂症患者分别服用奎硫平（n=31）与利培酮（n=33），治疗前及治疗后8周分别测定其空腹血清催乳素、瘦素、胰岛素、血糖水平，测身高与体质量，以体质量指数评定体脂情况，以胰岛素抵抗指数（HOMA-Insulin Resistance，HOMA-IR=空腹胰岛素×空腹血糖）评定胰岛素抵抗，以简明精神症状评定量表（BPRS）减分率评定药物疗效。结果治疗8周后利培酮组血清催乳素明显增加[治疗前（487．54±426．04）mlU／L，治疗后（1632．50±[005．31）mlU／L，P=0．000]。而奎硫平组催乳素浓度无明显改变[治疗前（531．47±420．91）mlU／L，治疗后（478．93±413．18）mlU／L，P=0．687]。多因素逐步回归显示催乳素与性别及不同药物有关。结论利培酮能增加血清催乳素水平，奎硫平对催乳素基本无影响，催乳素与药物疗效、体质量、瘦素及胰岛素抵抗等无直接联系。

Objective To study the influence of quetiapine and risperidon on seroprolactin and the relationship between semprolactin and drug efficiency, body weight and insulin resistance. Method 64 cases with schizophreniac which stopped taking drugs for more than 1 month were given quetiapine （ n= 31 ）and risperidon（ n= 33 ） respectively. Their fasting seropmlactin, leptin, insulin, blood sugar level, body height and weight were measured before and 8 weeks after treatment. To evaluate body lipid by BMI[ BMI = weight/height^2 （ kg/m^2 ） ]. Insulin resistance was evaluated by insulin resistance index（ HOMA-insulin resistance, HOMA-IR = fasting insulin × fasting blood suger） and drug efficiency was evaluated by BPRS scale. Results Seroprolactin of risperidon group obviously increased after treatment for 8 weeks than before treatment[ （487.54 ± 426.04） mlU/L vs（ 1632.50 ± 1 005. 31 ）mlU/L, P = 0. 000], but seropmlaetin of quetiapine group had no obvious changes [ before treatment vs after treatment（531.47 ±420.91 ） mlU/L vs （478.93 ± 413.18 ） mlU/L, P = 0. 687 ]. Regression of multiple factors showed that seroprolactin was associated with sex and different drugs. Conclusion Risperidon can increase the level of seroprolactin ,quetiapine has little effect on seroprolactin. There is no direct correlation among seroprolaetin, drug efficiency,weight, leptin and insulin resistance.