不同第二代抗精神病药对精神分裂症骨密度影响的2年随访研究

Two-year follow-up study about effects of long-term antipsychotic medication on bone mineral density in chronic schizophrenia patients

目的探讨长期服用不同抗精神病药的精神分裂症患者对骨密度的影响。方法选取2010年1月～2011年12月北京市海淀区精神卫生防治院住院精神分裂症患者50例,依据对泌乳素影响不同,分为泌乳素升高药物组（28例,使用利培酮）和泌乳素抑制药物组（22例,使用奥氮平或喹硫平）,接受单一药物治疗,随访2年。主要测定患者桡骨骨密度。结果随访2年后,泌乳素升高药物组与泌乳素抑制药物组骨密度分别改变（-0.95±0.88）和（-0.27±1.47）,两组比较差异有统计学意义（P=0.048）。2例出现单侧股骨颈骨折的患者均在泌乳素升高药物组。结论长期服用引起高泌乳素血症的抗精神病药物,会造成骨密度流失更加严重,骨质疏松发生率更高,骨折的风险显著增加。

Objective To explore bone mineral density（BMD） changes over two years in patients with schizophrenia taking prolactin-raising antipsychotics. Methods From January 2010 to December 2011, 50 inpatients with schizophrenia enrolled from Haidian Mental Health Hospital of Beijing City were divided into prolactin-raising group（given risperidone, 28 cases） and prolactin-sparing group（given olanzapine or quetiapine, 22 cases）. The BMD of radial bones were measured. Results After two years, the BMD alterations were（-0.95±0.88） and（-0.27±1.47） in prolactin-raising group and prolactin-sparing group, the difference was statistically significant（P = 0.048）. And hip fractures were occurred in 2 patients of prolactin-raising group. Conclusion In patients with schizophrenia taking long term prolactinraising antipsychotics, bone loss are more severe, and the rates of osteoporosis and hip fracture are higher.