不同抗精神病药物对精神分裂症患者血清PRL、MPRL水平的影响

Influences of different antipsychotics on serum PRL and MPRL levels in 168 schizophrenic patients

目的:探究抗精神病药物对精神分裂症患者血清催乳素(Prolactin,PRL)水平、巨泌乳素(Giant prolactin,MPRL)水平的影响。方法:选取我院2018年1月至2020年5月间收治的168例服用抗精神病药物治疗的精神分裂症患者进行前瞻性研究,所有患者随机分为四组(n=42),分别口服喹硫平50-350 mg,Bid;利培酮1-3 mg,Bid;阿立哌唑5-15 mg,Bid;奥氮平5-10 mg,Bid,治疗12 w。治疗前、治疗2、6、12 w后采用化学发光免疫测定血清PRL、酶联免疫吸附法(Enzyme-linked immunosorbent assay,ELISA)测定MPRL水平;同时采用精神分裂症阳性与阴性症状量表评估精神分裂症状,并记录不良反应发生率。结果:治疗12 w后,利培酮组患者血清PRL、MPRL水平明显高于喹硫平组、阿立哌唑组、奥氮平组(P<0.05);所有患者各维度精神分裂症状评分均明显低于治疗前(P<0.05),且组间无显著差异(P>0.05),不良反应发生率也无显著差异(P>0.05)。结论:喹硫平、利培酮、阿立哌唑、奥氮平治疗精神分裂症均能有效减轻临床症状,且效果相当;其中利培酮能显著升高血清PRL、MPRL水平。

Objective:To investigate the effects of antipsychotic drugs on serum Prolactin(PRL)and Giant Prolactin(MPRL)levels in patients with schizophrenia.Methods:A prospective study was conducted on 168 schizophrenic patients treated with antipsychotic drugs admitted to our hospital from January 2018 to May 2020.All patients were randomly divided into four groups(n=42),who were given quetiapine 50-350 mg Bid;Risperidone 1-3 mg Bid;Aripiprazole 5-15 mg Bid;Olanzapine 5-10 mg Bid,treatment for 12 weeks.Enzyme-linked immunosorbent(ELISA)assay was used to determine serum PRL level before treatment,2,6 and 12 weeks after treatment.Schizophrenia Positive and Negative Symptom Scale(PANSS)was used to evaluate schizophrenia symptoms and the incidence of adverse reactions was recorded.Results:After 12 w of treatment,the serum PRL and MPRL levels in risperidone group were significantly higher than those in quetiapine group,Aripiprazole group and Olanzapine group(P<0.05).Compared with before treatment,PANSS of all patients were significantly decreased(P<0.05),and there was no significant difference between the two groups(P>0.05),and the incidence of adverse reactions was not significantly different between the two groups(P>0.05).Conclusion:Quetiapine,risperidone,aripiprazole and olanzapine in the treatment of schizophrenia can effectively reduce the clinical symptoms,and the effect is similar,the patients are all tolerant.Risperidone can significantly increase serum PRL and MPRL levels,while other drugs have no obvious effect on lactation level.