抗精神病药致高泌乳素血症患者血清PRL、性激素6项水平检测及临床意义

Serum levels of megaprolactin and gonadal hormones in patients with hyperprolactinemia induced by antipsychotics and their clinical significance

目的探讨抗精神病药致高泌乳素血症患者血清巨泌乳素(MPRL)、性激素6项水平检测及临床意义。方法选择2017年6月至2018年10月湖州市第三人民医院接诊的精神分裂症女性患者105例进行研究,经过抗精神病药物氯氮平治疗2个月后,将患有高泌乳素血症患者50例作为观察组,未患有高泌乳素血症患者55例作为对照组。比较两组阴性症状评定量表(SANS)、阳性症状评定量表(SAPS)评分,测定并比较血清MPRL、孕酮、睾酮、雌二醇(E2)、催乳激素(PRL)、促黄体生成激素(LH)、卵泡刺激素(FSH)水平,采用Spearman相关性分析法分析血清MPRL水平与血清孕酮、E2、PRL、LH水平的相关性。结果观察组患者血清MPRL水平为(63.80±12.13)ng/mL,明显高于对照组的(59.07±9.84)ng/mL,差异有统计学意义(t=2.20,P=0.030);观察组患者血清孕酮、睾酮、E2、PRL、LH、FSH分别为(4.01±0.47)ng/mL、(5.59±1.15)ng/mL、(236.72±15.14)pg/mL、(127.30±12.40)ng/mL、(6.05±1.10)mIU/mL、(8.52±2.13)mIU/mL,对照组分别为(10.25±1.83)ng/mL、(6.01±1.20)ng/mL、(433.10±20.90)pg/mL、(50.58±6.22)ng/mL、(7.69±2.36)mIU/mL、(8.48±2.01)mIU/mL,观察组患者血清孕酮、E2、LH水平均低于对照组,PRL水平均高于对照组,差异均有统计学意义(t=23.41、54.66、4.63、40.61,均P<0.05),两组血清睾酮、FSH水平差异无统计学意义(t=1.82、0.09,P=0.071、0.921);经Spearman相关性分析法结果显示,血清MPRL与孕酮、E2均呈负相关,血清MPRL与PRL、LH均呈正相关(r=-0.42、-0.51、-0.68、0.70,均P<0.05)。结论在抗精神病药致高泌乳素血症患者中,血清MPRL、PRL有明显高表达,孕酮、E2、LH表达水平较低,MPRL、PRL、LH、孕酮、E2的表达水平与性腺激素的平衡具有明显相关性,该研究成果具有显著的创新性和科学性。

Objective To investigate serum levels of macroprolactin and gonadal hormones in patients with hyperprolactinemia induced by antipsychotics and their clinical significance.Methods A total of 105 female patients with schizophrenia who received treatment in Huzhou Third Municipal Hospital from June 2017 to October 2018 were included in this study.All these patients received the antipsychotic drug clozapine for 2 months.Then 50 patients with hyperprolactinemia were included in the observation group,and 55 patients who had no hyperprolactinemia were included in this control group.The scores of the Scale for the Assessment of Negative Symptoms and Scales for the Assessment of Positive Symptoms were compared between the two groups.Serum levels of macroprolactin,progesterone,testosterone,estradiol,prolactin,luteinizing hormone,and follicle-stimulating hormone were then compared between the two groups.The Spearman correlation analysis was used to analyze the correlation between serum macroprolactin level and serum progesterone,estradiol,prolactin,and luteinizing hormone levels.Results Serum macroprolactin level in the observation group was significantly higher than that in the control group[(63.80±12.13)ng/mL vs.(59.07±9.84)ng/mL,t=2.20,P=0.030].Serum levels of progesterone,testosterone,estradiol,prolactin,luteinizing hormone,and follicle-stimulating hormone were(4.01±0.47)ng/mL,(5.59±1.15)ng/mL,(236.72±15.14)pg/mL,(127.30±12.40)ng/mL,(6.05±1.10)mIU/mL,(8.52±2.13)mIU/mL,respectively,and they were(10.25±1.83)ng/mL,(6.01±1.20)ng/mL,(433.10±20.90)pg/mL,(50.58±6.22)ng/mL,(7.69±2.36)mIU/mL,(8.48±2.01)mIU/mL,respectively in the control group.Serum levels of progesterone,estradiol,and luteinizing hormone in the observation group were significantly lower than those in the control group,and serum level of prolactin in the observation group was significantly higher than that in the control group(t=23.41,54.66,4.63,40.61,all P<0.05).There were no significant differences in serum levels of testosterone and follicle-stimulating hormone between the two groups(t=1.82,0.09,P=0.071,0.921).Spearman correlation analysis results showed that serum macroprolactin level was negatively correlated with serum levels of progesterone and estradiol,and it was positively correlated with serum levels of prolactin and luteinizing hormone(r=-0.42,-0.51,-0.68,0.70,all P<0.05).Conclusion Serum levels of macroprolactin and prolactin were higher,and serum levels of progesterone,estradiol,and luteinizing hormone levels were lower in patients with hyperprolactinemia induced by antipsychotics than in patients without hyperprolactinemia.Serum levels of macroprolactin,prolactin,luteinizing hormone,progesterone,and estradiol were remarkably correlated with the balance of gonadal hormones.The study outcomes are of great innovation and science.