利培酮、奥氮平、阿立哌唑治疗对白细胞影响的随机对照研究

A randomized control study about the effects of risperidone,olanzapine and aripiprazole on leukocytes

目的探讨非典型抗精神病药物利培酮、奥氮平、阿立哌唑治疗对白细胞的影响。方法符合要求的120例精神分裂症患者随机给予利培酮、奥氮平、阿立哌唑治疗,分别在治疗前、治疗1个月末、2个月末、3个月末测量患者血常规、体重。结果共有111例患者完成随访。白细胞计数随着治疗时间的变化不同药物治疗组间存在显著差异(F交互=7.29,P<0.001),但不同药物组间以及不同药物治疗前后白细胞数并无差异,随访过程中三组均未出现白细胞降低到3.5×109/L的情况;利培酮组和阿立哌唑组治疗前后白细胞计数变化与基线白细胞水平呈负相关(利培酮组:r=-0.44,P<0.01,阿立哌唑组:r=-0.74,P<0.001),奥氮平组治疗前后白细胞计数变化与体重变化间存在正相关(r=0.61,P<0.001)。结论利培酮、奥氮平、阿立哌唑治疗对白细胞的影响相对较小,但白细胞计数随着治疗时间的变化不同药物治疗组间存在差异,值得临床关注。

Objective To investigate the effects of risperidone, olanzapine and aripiprazole on leukocytes. Methods A total of 120 schizophrenic patients were randomized into risperidone group, olanzapine group and aripiprazole group treated with corresponding antipsychotics for 3 months. Blood routine examination and body weight were measured at the baseline and at the end of the 1st, 2nd, 3rd month of the treatment. Results 111 patients completed the triM. There was significant difference in the dynamic change of leukocytes numbers among three groups （Finteraction = 7.29, P 〈 O. 001 ）. But no significant difference was found in leukocytes numbers in intergroup paired comparison, nor was in intragroup pre-and-post comparison. There was no patient whose leukocytes numbers decreased to below 3.5 × 10^9/L during the whole period of treatment. The dynamic changes of leukocytes numbers were significantly negatively correlated with the baseline of leukocytes in risperidone group （ r = - 0. 44, 0. 001 ）, and the dynamic change of leukocytes numbers was P 〈0.01 ） and aripiprazole group （ r = -0. 74, P 〈 significantly positively correlated with the dynamic change of body weight in olanzapine group （ r = 0.61, P 〈 0. 001 ）. Conclusion Risperidone, olanzapine and aripiprazole have mild effect on the leukocytes. But the dynamic changes of leukoeytes numbers is different among patients treated with the three antipsyehoties, which deserves special attention.