阿立哌唑治疗抗精神病药物所致高催乳素血症

A Control Study on Aripiprazole in the Treatment of Hyperprolactinaemaia by Antipsychotics

目的探讨阿立哌唑治疗抗精神病药物所致精神分裂症女性患者高催乳素血症的疗效及安全性。方法将86名服用抗精神病药物后出现高催乳素血症的精神分裂症女性患者,随机分为治疗组(阿立哌唑组)及对照组各43例,均维持原有治疗方案不变,治疗组加用阿立哌唑5mg/d,总疗程12周。于治疗前、治疗后第4、8、12周分别检测催乳素,同时观察记录高催乳素血症临床症状的变化,以阳性症状和阴性症状量表(PANSS)、精神药物副反应量表(TESS)评定对抗精神病药物疗效的影响及不良反应。结果治疗结束时,治疗组催乳素较基线下降,差异有统计学意义(t=28.97,P<0.01);对照组催乳素与基线比较,差异无显著性(t=0.74,P>0.05)。治疗组催乳素下降率(77.2±8.5)%高于对照组(-2.9±13.4)%(P<0.01)。治疗组患者闭经及泌乳等症状有改善;对照组症状无改善。两组PANSS总分均明显下降,与基线的差异有显著性(P<0.01),但组间差异无显著性(P>0.05)。两组不良反应总体发生率相当。结论阿立哌唑治疗抗精神病药物所致精神分裂症女性患者高催乳素血症安全、有效。

Objective To explore the efficacy and safety of aripiprazole in the treatment of female schizophrenia with antipsy- chotic induced hyperprolactinaemaia. Methods All 86 female schizophrenia with hyperprolactinaemaia after fixed dose antipsychot- ic treatment were randomly assigned to aripiprazole group （n ： 43）and control group （n = 43）, and received additional aripiprazole 5rag daily for 12 weeks respectively. The prolactin （PRL）level was measured at week 0,4,8,12,and the Positive and Negative Syn- drome Scale（PANSS）and Treatment Emergent Symptom Scale（TESS）were used to assess. Results Prolactin level was signifi- cantly reduced after the study compared with the baseline （（18.8± 7.4） ng/ml vs （80.6± 16.3） ng/ml3in aripiprazole group （t = 28. 97,P〈0. 01）. However there was no significant difference between pre-and post treatment in control group （t= 0. 74,P〉 0.05）. At week 12 ,the decline rate of prolactin level was significantly higher in aripiprazole group [（77. 2±8. 5）% ]than in control group [（- 2.9±13.4） ] 3 （P〈 0. 01 ）. Disappeament of amenia and spontaneous lactation were observed in aripiprazole group, while not any change occurred in control group. Compared with the baseline,the PANSS score showed significant reduction in both groups at the end of the study（P〈0. 01）,however there was no significant difference between aripiprazole and control group（P〉0.05）. The incidence of side effects showed no significant difference between aripiprazole and control group. Conclusion Aripipra- zole may be effective and safe in the treatment of female schizophrenia with antipsychotic induced hyperprolactinaemaia.