非典型抗精神病药对男性精神分裂症患者血清泌乳素水平及性功能的影响

Effects of atypical antipsychotics on serum prolactin and sexual function in male patients with schizophrenia

目的:探讨利培酮、奥氮平、喹硫平、阿立哌唑等非典型抗精神病药对男性精神分裂症患者泌乳素及性功能的影响。方法:将符合纳入标准的男性精神分裂症患者139例,随机分为利培酮组(36例)、奥氮平组(32例)、喹硫平组(34例)和阿立哌唑组(37例)。使用亚利桑那洲性经验量表(ASEX)评估4组患者的性功能;治疗前后,检测4组患者血清泌乳素水平。以阳性与阴性症状量表(PANSS)及副反应量表(TESS)评估4组患者的疗效和不良反应。4组患者均观察8周。结果:治疗第8周末,利培酮组患者的性功能量表总分及各因子分均较治疗前升高;奥氮平组患者的性功能总分、性唤起、性高潮和性满意度因子分高于治疗前;喹硫平组患者的性功能总分和性满意度因子得分有所升高;阿立哌唑组患者无明显变化。治疗第8周末,利培酮组和奥氮平组患者的血清泌乳素水平高于基线,喹硫平组和阿立哌唑组患者无明显变化。结论:非典型抗精神病药对男性精神分裂症患者血清泌乳素水平及性功能的影响有所差异。

Objective To explore effects of Risperidone, Olanzapine, Quetiapine and Arilpiprazole on prolactin and sexualfunction in male patients with schizophrenia. Methods： 139 male patients with schizophrenia meeting inclusion criteria were randomlydivided into Risperidone group（n=36）, Olanzapine group（n= 32）, Quetiapine group（n= 34） and Aripiprazole group（n= 37）. Allpatients were assessed with Arizona sexual experience scale（ASEX） for the sexual function and the serum levels of prolactin of the patients in each group were measured with enzyme linked immunosorbent assay before and 8 weeks after the treatment. The positive andnegative syndrome scale（PANSS） and treatment emergent symptom scale（TESS） were used to assess the efficacies and adverse reactions. Results： 8 weeks after the treatment,the total score and the factor scores of Arizona sexual experience scale increased in risperidone group; the scores of sexual arousal, orgasm, and sexual satisfactory degree and the total factor score of sexual function were significantly higher than those before the treatment in Olanzapine group;the sexual satisfactory degree score and total factor score of sexualfunction increased significantly in Quetiapine group;there were no change of the scores of Arizona sexual experience scale in Aripiprazolegroup. The serum levels of prolactin were significantly higher in Risperidone group and Olanzapine group 8 weeks after the treatmentthan those at the baseline; however, there were no significant changes in Quetiapine group and Aripiprazole group. Conclusions： Theatypical antipsychotics have different impacts on prolactin and sexual function in male patients with schizophrenia.