氨磺必利与奥氮平对首发精神分裂症患者血清泌乳素水平的影响研究

The effects of amisulpride and olanzapine treatment on PRL levels in patients with first-episode schizophrenia

目的探究氨磺必利与奥氮平对首发精神分裂症患者血清泌乳素(PRL)水平的影响及安全性。方法选取136例首发精神分裂症患者,采用随机数字表法分为两组,每组68例。氨磺必利组采用口服氨磺必利治疗(第1周,200 mg/d,1次/d;第2周及以后,800 mg/d,2次/d),奥氮平组通过口服奥氮平治疗(第1周,5 mg/d,1次/d;第2周及以后,20 mg/d,2次/d),两组均治疗两个月,比较两组性激素水平,阳性与阴性症状量表(PANSS)、认知功能成套测验系统(MCCB)、韦氏成人记忆量表(WMS-RS)、不良反应症状量表(TESS)评分。结果治疗两个月后,两组PANSS总分及各项评分较治疗前均显著下降,但两组间比较,差异无统计学意义(P>0.05);两组MCCB各项评分较治疗前均显著改善(P<0.05),且氨磺必利组的连线测试、工作记忆、操作速度均低于奥氮平组(P<0.05);两组WMS-RS评分较治疗前均显著改善(P<0.05),但两组间比较,差异无统计学意义(P>0.05);氨磺必利组震颤发生率高于奥氮平组,嗜睡发生率、肝功异常发生率低于奥氮平组;两组PRL水平较治疗前显著升高(P<0.05),但雌二醇(E2)、睾酮(TESTO)水平比较差异无统计学意义(P>0.05),氨磺必利组的PRL水平显著高于奥氮平组(P<0.05)。结论氨磺必利与奥氮平对首发精神分裂症患者治疗效果差异无统计学意义(P>0.05),但后者可以有效降低血清PRL水平,值得应用于临床。

Objective To observe the effect of amisulpride and olanzapine on serum prolactin(PRL) levels in patients with first-episode schizophrenia. Methods A total of 136 patients with first-episode schizophrenia were randomly divided into two groups(n=68).Patients in the amisulpride group was treated with oral amisulpride and those in the olanzapine group was treated with oral olanzapine for two months.The sex hormone levels after treatment were compared between the two groups.The positive and negative symptom scale(PANSS), the cognitive function test system(MCCB), the wechsler adult memory scale(WMS-RS), and the outcome symptoms scale(TESS) score were used for the clinical evaluation. Results After two months of treatment, the total scores and scores of PANSS in the two groups were significantly lower than before, but the difference between the two groups was not significant(P>0.05).The scores of MCCB in both groups were significantly higher than before treatment(P<0.05).The scores of connection test, working memory, operation speed were lower in amisulpride group than those in the olanzapine group(P<0.05).The WMS-RS scores of the two groups were significantly improved after treatment(P<0.05), but the difference between the two groups was not significant(P>0.05).The incidence of tremor in the amisulpride group was higher while the incidence of lethargy and abnormal liver function were lower compared to the olanzapine group.The levels of PRL in the two groups significantly increased after treatment(P<0.05),but the differences in estradiol2(E2)level and testosterone(TESTO)level before and after treatment were not statistically significant(P>0.05).The PRL level in the amisulpride group was significantly higher than that in the olanzapine group(P<0.05). Conclusions The clinical effects of amisulpride and olanzapine are not significantly different in the treatment of first-episode schizophrenia.The latter can effectively reduce serum PRL levels and is worthy of clinical application.