喹硫平和利培酮对女性精神分裂症患者甲状腺素的影响

Effects of quetiapine and risperidone on thyroxine in female patients with schizophrenia

目的探讨喹硫平、利培酮对女性精神分裂症患者甲状腺素的影响。方法选取119例新入院女性精神分裂症患者,根据用药情况分为喹硫平组(59例)和利培酮组(60例)。喹硫平组使用喹硫平单一用药治疗,利培酮组使用利培酮单一用药治疗。测量患者入院时及入院后第4、8周末游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、总三碘甲腺原氨酸(TT3)、总甲状腺素(TT4)。结果入院后第4周末利培酮组TSH较入院时升高(P<0.01),FT3、FT4、TT3、TT4指标均较入院时降低(P<0.01);入院后第8周末两组TSH均较入院时升高(P<0.01),TT3、TT4、FT3、FT4均较入院时降低(P<0.01);入院后第8周末喹硫平组TSH水平较入院后第4周末升高(P<0.01);利培酮组入院后第8周末TT3、FT3、TT4均较入院后第4周末时降低(P<0.05)。入院后第4、8周末利培酮组FT3、FT4、TT3、TT4均高于喹硫平组(P<0.01)。喹硫平、利培酮对TSH的影响无统计学意义(P>0.05);对FT3、FT4的影响均存在统计学意义(P<0.01)。喹硫平所致的FT3、FT4异常发生率高于利培酮(P<0.05)。结论喹硫平、利培酮均可引起TSH的升高;喹硫平对FT3、FT4的影响较利培酮更为明显,所致的FT3、FT4异常发生率亦高于利培酮,所以在临床治疗过程中,定期检测甲状腺激素水平对于合理选择药物具有重要意义。

Objective To explore the effects of quetiapine and risperidone on thyroxine in female patients with schizophrenia.Methods A total of 119 newly admitted female patients with schizophrenia were selected and divided into quetiapine group(59 cases)treated with quetiapine alone,and risperidone group(60 cases)treated with risperidone alone.The levels of free triiodothyronine(FT3),free thyroxine(FT4),thyrotropin(TSH),total triiodothyronine(TT3)and total thyroxine(TT4)were measured at admission,and at the 4th,8th weekends after admission.Results At the 4th weekend after admission,the TSH level in risperidone group increased significantly and the levels of FT3,FT4,TT3,TT4 decreased significantly compared with those at admission(P<0.01).At the 8th weekend after admission,the TSH levels in both groups increased significantly and the levels of FT3,FT4,TT3,TT4 decreased significantly compared with those at admission(P<0.01).At the 8th weekend after admission,the TSH level increased in quetiapine group(P<0.01)and the levels of TT3,FT3,TT4 decreased in risperidone group(P<0.05)compared with those at the 4th weekend after admission.At the 4th,8th weekends after admission,the levels of FT3,FT4,TT3,TT4 in risperidone group were significantly higher than those in quetiapine group(P<0.01).There was no significant difference in TSH between two groups(P>0.05),but there existed significant differences in FT3 and FT4 between two groups(P<0.01).The incidence rates of abnormities in FT3,FT4 induced by quetiapine were significantly higher than those induced by risperidone(P<0.05).Conclusion Quetiapine and risperidone may cause the increase of TSH.The effects of quetiapine on FT3 and FT4 are more obvious than those of risperidone,and the incidence rates of abnormities in FT3 and FT4 induced by quetiapine are also significantly higher than those induced by risperidone.Therefore,regular detection of thyroid hormone level is of great significance for reasonable selection of drugs in clinical treatment.