联合不同剂量阿立哌唑对高泌乳素血症的疗效研究

Effect of aripiprazole combined with different doses on hyperprolactinemia

目的:研究联合使用不同剂量阿立哌唑对患有药源性高泌乳素血症的精神分裂症患者泌乳素水平及精神症状的影响。方法:120例住院精神分裂症患者,正在服用非典型抗精神病药物且泌乳素水平升高,随机分成三组。试验组1:原有治疗联合阿立哌唑2.5 mg/d,试验组2:原有治疗联合阿立哌唑5mg/d,对照组:维持原有治疗。共治疗6周,在基线及第6周末分别检测血清泌乳素水平,采用阳性和阴性症状量表(PANSS)和不良反应症状量表(TESS)评定临床疗效和不良反应。结果:试验组1共39例,试验组2共36例,对照组38例完成研究。第6周末,两组试验组的PANSS总分、阴性症状分与对照组比较,差异均有统计学意义(P<0.05);第6周末试验组2的阳性症状分(20.61±4.47)分,与试验组1的(17.69±4.14)分、对照组的(17.70±3.79)分比较,差异均有统计学意义(P<0.05)。治疗6周后,两组试验组血清泌乳素水平与对照组相比,差异均有统计学意义(P<0.05)。结论:联合小剂量阿立哌唑(2.5 mg/d或者5 mg/d)均能改善非典型抗精神病药物所致的高泌乳素血症;联用2.5 mg/d的阿立哌唑不影响精神症状的波动,安全性好。

Objective To study the effects of different doses of aripiprazole on prolactin levels and psychiatric symptoms in schizophrenic patients with drug-induced hyperprolactinemia.Method A total of 120 patients with schizophrenia who were taking atypical antipsychotics and had elevated prolactin levels were randomly assigned to three groups.Experimental group 1:the original treatment combined with aripiprazole was 2.5 mg/d;Experimental group 2:the original treatment combined with aripiprazole was 5 mg/d;Control group:maintained original treatment.At baseline and after 6 weeks of treatment,serum prolactin levels were measured,the positive and negative symptom scale(PANSS)and the treatment emergent symptoms scale(TESS)were used to assess clinical efficacy and adverse reactions.Results There were 39 cases in the experimental group 1,36 cases in the experimental group 2 and 38 cases in the control group completed the study.At the 6th weekend,The total PANSS scores and negative symptom scores of the two Experimental groups were statistically significant compared with those of the control group(P<0.05).The positive symptom score(20.61±4.47)of the experimental group 2 at the end of the 6th week was statistically significant compared with that of the experimental group 1(17.69±4.14)and the control group(17.70±3.79)(P<0.05).After 6 weeks of treatment,serum prolactin levels in the two experimental groups were statistically significant compared with those in the control group(P<0.05).Conclusion In combination with small doses of aripiprazole(2.5 mg/d or 5 mg/d),hyperprolactinemia induced by atypical antipsychotics was improved.Aripiprazole combined with 2.5 mg/d did not affect the fluctuation of mental symptoms and was safe.