抗精神病药血液浓度与男性精神分裂症患者性功能的相关性研究

Correlation study of antipsychotic drug haemoconc- entration and male sexual function with schizophrenia

目的：探讨氯丙嗪、氯氮平不同血药浓度对男性精神分裂症患者性功能的影响及相关性。方法：收集上海市徐汇区精神卫生中心门诊男性精神分裂症105例，随机分为氯丙嗪组与氯氮平组，两组药物剂量分别为（296±86）mg／d、（278±92）mg／d，并分别在第4周、8周、12周应用高效液相色谱仪（HPLC）检测氯丙嗪、氯氮平的药物血液浓度，同时应用副反应量表（TESS）进行评定，所有病例在入组时使用阳性与阴性症状量表（PANSS）进行基线水平测定，并在治疗前、第4周、8周、12周末用简明男性性功能量表评定性功能。结果：①在第4周、8周、12周末，随着药物剂量增加，药物浓度也相应增加。在一定血药浓度范围内，血药浓度与性功能的下降呈现出显著正相关（P〈0．01）。②药物血浓度与TESS评分呈现一定相关性（P〈0．05），对性功能产生影响（P〈0．05）。结论：氯丙嗪、氯氮平的药物在一定范围内血浓度越高，对男性性功能影响越大，呈现显著正相关；而药物的副反应随血药浓度递增而增大，显现出一定的正相关性，对性功能产生一定影响。

Objective： To study different chloropromazine＆clozapine haemeeoncentration influence male sexual function with schizophrenia and the correlation.Methods： 105 male outpatients with schizophrenia in Shanghai Xuhui district mental health center, were randomly divided into two groups of chloropromasine and clozapine, the dose of chloropromazine and clozapine respectively was （296 ± 86） mg/d and （278 ± 92）mg/d, detect chloropromazine＆clozapine haemeeoncentration with high performance liquid chromatogram（ HPLC）, 4 weeks, 8 weeks, 12 weeks after treatment. Also the patients were evaluated with treatment emergent symptom scale （TESS） ,4 weeks,8 weeks, 12 weeks after treatment. All the patients were evaluated with positive and negative syndrome scale（PANSS） before treatment, and evaluate sexual function with brief male sexual function scale before treatment and 4 weeks , 8 weeks, 12 weeks after treatment. Results： ①With the dose being increased constantly, the heemeeoncentration was higher correlatedly 4weeks,8 weeks, 12 Weeks after treatment. Within a certain haemoconcentration, there were significant relationship between haemeeoncentration and sexual function impairment （ P 〈 0.01 ）. ②There were a certain relationship between haemeeoncentration and TESS score（ P 〈 0.05）, TESS score influence male sexual function. Conclusion： Within a certain chloropromazine ＆clozapine haemeeoncentration, higher haemoconcentration, higher impairment to sexual function, there were significant relationship between heemoconcentration and sexual function; also severely side effect with the haemoconcentration higher, there were a certain relationship bet ween haemoconcentration and side effect, side effect also influence male sexual function.