喹硫平、阿立哌唑对精神分裂症患者血小板5-羟色胺水平的影响

The effects of quefiapine and aripiprazole on platelet 5-HT concentrations in patients with schizophrenia

目的了解新型抗精神病药物喹硫平、阿立哌唑对急性期精神分裂症患者血小板5-羟色胺（5-HT）水平的影响。方法将符合ICD-10入组标准的精神分裂症患者68例按入院的先后顺序分为喹硫平组34例和阿立哌唑组34例，用高效液相色谱仪（HPLC-ECD）在治疗前后测定血小板5-HT水平．在治疗始、4周、8周用阳性和阴性症状量表（PANSS）评定精神症状。用副反应量表（TESS）评定不良反应。结果2组患者治疗后血小板5-HT水平有一定程度升高，但差异无统计学意义（P〉0．05），喹硫平组治疗前（458，89±233．36）ng／10^9，治疗后（554．31±313．22）ng／10^9（t=1．709，P=0．099）；阿立哌唑组治疗前（409．83±149．32）ng／10^9，治疗后（421．27±245．96）ng／10^9（t=0．321，P=0．819）。2组间治疗后血小板5-HT水平及变化率的差异均无统计学意义（P〉0．05）。多元逐步回归分析显示，喹硫平组血小板5-HT水平变化率与剂量呈正相关（r=0．385，P=0．039）；阿立哌唑组水平变化率与PANSS减分率呈正相关（r=0．391，P=0．040）。结论在精神分裂症患者治疗过程中，精神症状的变化、药物剂量的大小可能与血小板5-HT水平有着密切关系。

Objective To study the effects caused by novel antipsychotics quetlapine and ariplprazole on concentrations of platelet 5-HT in patients with schizophrenia, and to explore the relationships among the change of platelet 5-HT concentrations,psychiatric symptoms and the sensitivity of therapy. Methods Sixty-eight patients with schizophrenia meeting International Classification of Diseascs-lO （ICD-10） were enrolled in the study. They were divided into quetiapine group （ n = 34 ） and aripiprazole group （ n--34） according to the sequence of admis- sion. The platelet 5-HT concentrations were measured with high performance liquid chromatography method（ HPLC- ECD）. The positive and negative syndrome scale （PANSS） was used to evaluate the psychopathology. Treatment emergent symptom scale （TESS） was used to evaluate the side effects. PANSS,TESS were used at pre-treatment, the end of 4th and 8th week of treatment. Results The platelet 5-HT concentrations in two groups were higher after 8 weeks treatment,but had no statistically significant difference （P 〉 O. 05）. In quetiapine group, the platelet 5-HT concentration was （458.89 ＋ 233.36） ng/10^9 at the pre-treatment, and （ 554.31 ＋ 313.22 ） ng/109 at the end of treatment （t = 1. 709, P = 0. 099）. In aripiprazole group, the platelet 5-HT concentration was （ 409.83 ＋ 149.32） ng/109 at the pretreatment, and （421.27 ＋ 245.96） ng/109 at the end of treatment （t = 0. 321, P = 0.819 ）. There was no difference between two groups （P 〉 0.05 ）. Stepwise regression analysis showed the changing rate of platelet 5-HT concentrations was positively correlated with the dosage of quetiapine （r = 0. 385, P= 0. 039 ）. It was positively correlated with the decreasing rate of PANSS in aripiprazole group（r =0. 391, P=0. 040）. Condusion The changes of psychiatric symptoms and the dosages of antipsychotics maybe have intimate relationships with platelet 5-HT concentrations in the course of medication.