非典型抗精神病药对男性精神分裂症患者性功能影响的初步分析

Atypical antipsychotics on sexual function in male patients with schizophrenia

目的探讨喹硫平、利培酮、奥氮平及氯氮平对男性精神分裂症患者性功能影响的差异。方法将门诊就诊的男性精神分裂症患者145例,分为喹硫平组30例、利培酮组47例、奥氮平组31例及氯氮平组37例。检测各组患者血清泌乳素水平。使用简明男性性功能量表、阳性与阴性综合征量表(PANSS)评估性功能及精神症状,用副反应量表(TESS)评估药物治疗的不良反应。共观察8周。结果治疗第8周末,利培酮组的性功能量表总分及因子分均较治疗前降低,奥氮平组的性唤起因子及性功能因子得分有所下降,氯氮平组的性满意度因子及性功能因子得分有所下降。喹硫平组得分无明显变化。利培酮组和奥氮平组治疗第8周末的血清泌乳素水平高于基线水平[利培酮组:(12±5)ng/ml,(20±6)ng/ml,t=13.92,P<0.01;奥氮平组:(13±6)ng/ml,(18±5)ng/ml,t=8.27,P<0.01],喹硫平组和氯氮平组无明显变化。影响男性精神分裂症患者性功能的因素有泌乳素、年龄及TESS分。结论常见非典型抗精神病药物对男性精神分裂症患者的性功能影响有所不同。

Objective： To evaluate the effeets of quetiapine, risperidone, olanzapine and elozapine on sexual function in male patients with schizophrenia. Methods： One hundred and forty -five male patients with schizophrenia were randomly divided into quetiapine group （ n = 30 ）, risperidone group （ n = 47 ）, olanzapine group（n = 31 ）and elozapine group（ n = 37 ）. The serum levels of prolaetin of patients in each group were measured with enzyme linked immunosorbent assay before treatment and 8 weeks after treatment. All patients were assessed with brief male sexual function scale, the positive and negative syndrome scale （ PANSS ） and treatment emergent symptom scale （TESS） before treatment and 8 weeks after treatment. Resets： After 8 - week treatment, the faetor scores and total seore of brief male sexual function seale decreased in risperidone group, the scores of sexual arousal and the total factors of sexual function were significantly lower than that at the baseline in olazapine group and the sexual satisfactory degree and total factor score of sexual function was significantly lower in elozapine group . The was no ehange of scores of brief male sexual function scale in quetiapine group. The serum level of prolaetin was signifieantly higher in risperidone group [ （ 12 ±5 ） ng/ml vs. （ 20 ± 6 ） ng,/ml, t = 13.92, P 〈 0.01 ] and olazapine group [ （ 13± 6 ） ng/ml, （ 18 ±5 ） ng/ml, t = 8.27, P 〈 0.01 ] after 8 - week treatment than that at the baseline level . There was no significant change in quetiapine group and elozapine group. The sexual function of male patients with schizophrenia was strongly associated with the level of serum prolaetin, age and the score of TESS. Conclusion：The atypical antipsychties have different impact on sexual function in male patients with schizophrenia.