非典型抗精神病药对精神分裂症患者骨代谢的影响

The effects of atypical antipsychotics on bone metabolism in patients with schizophrenia

目的:探讨非典型抗精神病药对精神分裂症患者骨代谢标志物的影响。方法:对连续服用非典型抗精神病药>6个月的门诊或住院精神分裂症患者40例(研究组)及40名体检健康人(对照组)血液中性激素3项(泌乳素、雌二醇和睾酮)、甲状腺功能5项(总甲状腺激素、总三碘甲状腺激素、促甲状腺激素、游离甲状腺激素和游离三碘甲状腺激素)及骨代谢标志物5项(骨钙素、甲状旁腺激素、Ⅰ型胶原羧基端前肽、25-羟维生素D和β-型胶原分解产物)水平进行检测和比较。结果:研究组血骨钙素、Ⅰ型胶原羧基端前肽和β-型胶原分解产物水平显著升高,而维生素D和甲状旁腺激素水平显著下降(P均<0.05)。重复测量方差分析显示,组间主效应显著,除β-型胶原分解产物性别主效应不显著外其他指标性别主效应显著,交互效应均不显著。骨代谢标志物水平与性激素水平及甲状腺功能指标不相关。结论:非典型抗精神病药物对精神分裂症患者的骨代谢标志物可产生一定的影响。

Objective： To explore the effects of atypical antipsychotics on bone metabolism in schizophrenia patients. Method： Forty 18 to 40 years old schizophrenic patients（study group） who received atypical antipsychotics treatment for over 6 months,and matched 40 normal individuals（control group） were enrolled in this study. Serum estradiol（E2）,testosterone（T）,prolactin（PRL）,thyroid stimulating hormone（TSH）,free triiodothyromine（FT3）,free thyroxine（FT4）,total thriiodothyronine（TT3）,total thyroxine（TT4）,osteocalcin（OC）,parathyroid hormone（PTH）,type Ⅰcollagen carboxyl terminal propeptide（PTNP）,25-hydroxy vitamin D（Vit D-T） and β type collagen breakdown products（β-CTX） were measured. Results： The levels of OC,β-CTX and PTNP in the study group were significantly increased,while Vit D-T and PTH were significantly decreased than those in the control group（all P 〈0. 05）. The repeated measurement variance analysis indicated that the main effect significantly between groups,other indicators gender main effect were remarkable exceptedβ-CTX; and the interaction effects were not significant in all of the indicators. The levels of bone metabolic markers were not related to the sex hormone levels and thyroid function index. Conclusion： Atypical antipsychotics may affect bone metabolism in schizophrenic patients.