国产利培酮对男性精神分裂症患者催乳素影响的临床研究

目的探讨国产利培酮（索乐）对精神分裂症男性患者血清催乳素（PRL）水平影响。方法将60例符合中国精神疾病障碍分类第3版（CCMD-3）精神分裂症诊断标准的男性患者随机分为利培酮（索乐）组（30例）和氟哌啶醇组（30例）,采用酶联免疫法测定两组治疗前后的PRL水平;采用PANSS量表评定两组临床疗效。结果①两组治疗8周末的PANSS量表评分均显著低于治疗前（P〈0．01）;②治疗前利培酮（索乐）组与氟哌啶醇组的PRL水平差异无统计学意义;治疗后利培酮（索乐）组与氟哌啶醇组的PRL水平均比治疗前升高,但两组间无显著性差异（P〉0．05）。结论国产利培酮（索乐）和氟哌啶醇均能升高患者的PRL水平,但两者差异无显著性。     

利培酮对首发精神分裂症患者的疗效观察及与血浆催乳素水平的相关性研究

目的探讨非典型抗精神病药利培酮对首发精神分裂症患者血浆催乳素(PRL)水平的影响及其与疗效的关系。方法对30例符合CCMD-Ⅲ诊断标准的首发精神分裂症患者(治疗组) 在治疗前后及30例健康自愿者(对照组)的血浆PRL水平用放射免疫法进行检测。用利培酮治疗12 周,采用阳性和阴性症状量表(PAN SS)在治疗前后分别进行评定。结果患者组治疗前血浆PRL水平低于对照组,差异有统计学意义(P<0．05);治疗组治疗后血浆PRL水平明显高于治疗前(P< 0．01);治疗前、后在PAN SS总分及其因子分上差异均有显著性意义(P<0．05)。治疗后PRL水平较高、治疗前后差异较大或治疗前PRL水平较高者,疗效较好,尤其是阳性症状改善明显。结论利培酮治疗明显增加血浆PRL水平;且治疗前后血浆PRL水平与疗效相关,主要与阳性症状的疗效有关。     

利培酮治疗精神分裂症71例

目的　观察利培酮治疗精神分裂症的临床疗效。方法　选择符合CCMD-2-R有关精神分裂症诊断标准,且BPRS总分≥18分　,服用利培酮满12　wk的精神分裂症病人,分别用治疗前　、后BPRS总分的减分率评定临床疗效。结果　71例在治疗12　wk后平均减分率为(64.2±9.2)%,其中痊愈率9.9%（7/71）,显效率84.5%（60/71）,进步5.6%（4/71）,无效0（0/71）,总有效率为94.4%。结论　利培酮治疗精神分裂症疗效显著。     

利培酮治疗精神分裂症与患者血浆高香草酸浓度的关系

目的:探讨精神分裂症患者多巴胺代谢产物一血浆高香草酸(pHVA)含量的变化与利培酮药物治疗的临床意义.方法:23例精神分裂症患者用利培酮治疗6个月,于治疗前和治疗6个月后采用高液相色谱连接电化学分析仪测定pHVA;患者组用阳性和阴性症状量表(PANSS)评定临床疗效,并与25名健康者对照.结果:(1)与25例健康对照组比较,患者组在治疗前pHVA显著高于对照组;(2)患者组治疗6个月后,其pHVA降低值与PANSS总分的减分差值呈正相关.结论:一些以阳性症状为主的精神分裂症患者其pHVA含量高于正常组,利培酮对该类患者的疗效与降低pHVA含量相关.提示观察pHVA变化可能作为判断利培酮药物疗效的一个客观指标.利培酮减低中枢多巴胺转化,从而改善精神症状,可能为其作用机制之一.     

利培酮与氯丙嗪治疗精神分裂症的随机对照研究

利培酮片和氯丙嗪片治疗精神分裂症病人，利培酮组３０例，氯丙嗪组３０例。经８周治疗，结果显示：利培酮与氯丙嗪疗效相似，但利培酮起效时间罗氯丙嗪早。对阴性症状的疗效优于氯丙嗪，县锥登体外系副反应、植物神经系统副反应、体位性低血压及药物性皮疹、心电图改变均较氯丙嗪少见     

利培酮与氯丙嗪治疗精神分裂症的对照研究

目的：了解利培酮、氯丙嗪治疗精神分裂症患者的疗效及不良反应。     

利培酮治疗儿童精神分裂症30例

目的 观察利培酮治疗儿童精神分裂症的有效性和安全性。方法 对30例患者进行开放性研究，均符合CCMD-Ⅱ—R，且BPRS评分≥40分，利培酮1—4mg／d，疗程8周。以简明精神病评定量表(BPRS)减分率评定疗效，以不良反应评定量表(TESS)观察副作用。结果 利培酮治疗儿童精神分裂症疗效肯定，有效率87％，显效率70％，副作用有困倦、口干、头晕、静坐不能、月经紊乱等，症状多为轻度和中度，均能耐受，且多数症状可自行缓解。结论 利培酮治疗儿童精神分裂症有效、安全，值得临床推广。     

利培酮治疗社区首发精神分裂症的体会

利培酮是苯并异恶唑衍生物,对5HT2和D2受体平衡有拮抗作用,国内大量研究证明[1],利培酮是一种对阳性症状与阴性症状均有效的新型抗精神病药物,且安全性好,而这些药理特点比较适合社区治疗精神病。作者于2000年2月～6月在社区应用利培酮治疗首发精神分裂症患者共23例,以探讨利培酮在社区治疗的有效性和安全性。1　一般材料　入组对象均符合CCMD-2R精神分裂症诊断标准,共23例,临床分型:偏执型10例,未定型13例,其中男14例,女9例;年龄17～42岁,平均26.3±6.2岁,总病程3～11个月,排除有严重躯体和神经系统疾病者。2　给药方法　采用利培酮片…     

利培酮短期治疗的男性精神分裂症患者催乳素水平对胰岛素敏感性的影响

目的初步探讨利培酮短期治疗的男性精神分裂症患者催乳素水平对胰岛素敏感性的影响。方法将符合入组标准的51例利培酮治疗2⁶周的住院精神分裂症患者依据催乳素水平分为A组(催乳素≥800 mIU·L6周的住院精神分裂症患者依据催乳素水平分为A组(催乳素≥800 mIU·L^(-1))27例和B组(催乳素<800 mIU·L(-1))27例和B组(催乳素<800 mIU·L^(-1))24例,比较两组的胰岛素敏感性指标和体重指数(BMI);依据BMI分为正常体重组(BMI 18.5(-1))24例,比较两组的胰岛素敏感性指标和体重指数(BMI);依据BMI分为正常体重组(BMI 18.5²3.9 kg·m23.9 kg·m^(-2))29例和超重组(BMI≥24 kg·m(-2))29例和超重组(BMI≥24 kg·m^(-2))22例,比较两组的血清催乳素和胰岛素敏感性指标。结果 A、B两组空腹胰岛素(FINS)、稳态模型评估胰岛素抵抗指数(HONA-IR)、定量胰岛素敏感性检测指数(QUICKI)均无显著差异(P>0.05)。正常体重组与超重组的催乳素水平无显著差异(P>0.05);超重组FINS、HOMA-IR高于正常体重组(P<0.01),超重组QUICKI低于正常体重组(P<0.01)。结论利培酮短期治疗后的男性精神分裂症患者中体重超重者胰岛素敏感性降低,而催乳素水平不影响患者的体重及胰岛素敏感性。     

阿立哌唑和利培酮治疗老年性精神分裂症的对照研究

目的探讨阿立哌唑对老年性精神分裂症患者的疗效、不良反应及生存质量的影响。方法将80例老年性精神分裂症患者随机分为阿立哌唑组与利培酮组,治疗观察12周。以阳性和阴性症状量表（PANSS）、世界卫生组织生活质量量表（WHQOL-100）、治疗中出现的症状量表（TESS）评定疗效、生存质量及不良反应。结果阿立哌唑组与利培酮组疗效相当,两组患者的PANSS评分均明显减少,差异有显著性（P〈0.01）;两组间无显著差异（P〉0.05）。两组WHQOL-100评分均较治疗前有显著改善（P〈0.01）,两组间无显著差异（P〉0.05）。阿立哌唑组锥体外系反应、心动过速及体重增加等不良反应发生率显著低于利培酮组,差异有显著性（P〈0.01）。结论阿立哌唑对老年性精神分裂症有良好的疗效,能有效改善患者的生存质量,且安全性高,依从性好,适合老年性精神分裂症患者使用。     

阿立哌唑与利培酮治疗女性精神分裂症对照研究

目的：比较阿立哌唑和利培酮治疗女性精神分裂症患者的疗效及安全性。方法：女性精神分裂症患者60例,随机分为阿立哌唑组30例和利培酮组30例,疗程12周。采用阳性与阴性症状量表（PANSS）评价疗效,治疗中采用副作用量表（TESS）及实验室检查评价安全性。结果：阿立哌唑组显效率为75％,有效率为89．29％,利培酮组分别为73．08％和92．31％,两组结果无显著差异;阿立哌唑组体质量较治疗前无显著增加,利培酮组体质量增加明显,且出现多例闭经。结论：阿立哌唑治疗女性精神分裂症疗效与利培酮相当,且较为安全。     

Effects of dexamethasone on neuroendocrine and psychological responses to L-tryptophan infusion

5-Hydroxytryptamine_1A (5-HT_1A) receptors have been shown to be suppressed by corticosteroid hormones in a variety of animal experimental paradigms. This effect may be central to the pathophysiology of severe clinical depressive illness, a condition in which 5-HT_1A receptor function is reduced and corticosteroid hormones are elevated. Evidence suggests that the growth hormone (GH) response to L-tryptophan (L-TRP) is mediated by 5-HT_1A receptors. This response has been shown to be reduced following acute administration of hydrocortisone. The purpose of this study was to examine the effects of acute administration of dexamethasone, in normal volunteers, on hormonal and psychological responses to L-TRP infusion. Methods: Sixteen healthy male volunteers took part in a random order, double blind study, in which 5 mg dexamethasone or placebo was administered 11 h before infusion of L-TRP. Results: Pre-treatment with dexamethasone had no effect on the GH response to the infusion. However, baseline prolactin (PRL) was significantly reduced, as was the prolactin response to the infusion. Conclusions: These data contrast with a previous study using hydrocortisone in the same paradigm and demonstrate important functional differences between dexamethasone and hydrocortisone. Received: 5 June 1998/Final version: 25 September 1998     

阿立哌唑与利培酮治疗女性精神分裂症的对比分析

目的比较阿立哌唑与利培酮对女性精神分裂症患者的疗效和不良反应。方法将符合入组条件的87例患者随机分成2组,分别给予阿立哌唑和利培酮治疗,观察8周。于治疗后2、4、6、8周末用阳性症状与阴性症状量表(PANSS)和副反应量表(TESS)评定疗效和不良反应。结果研究过程中脱落3例。治疗后,两组患者PANSS评分均明显下降(P<0.01)。阿立哌唑组痊愈率50%,有效率90.5%,利培酮组痊愈率47.6%,有效率92.9%,两组比较差异无统计学意义(P>0.05)。两组不良反应主要表现为头昏、兴奋激越、恶心呕吐、锥体外系反应、心电图异常、嗜睡、失眠、便秘、体重增加、泌乳、月经紊乱等方面,其中阿立哌唑引发的锥体外系反应、体重增加、泌乳、月经紊乱明显少于利培酮(P<0.05)。结论阿立哌唑和利培酮对女性精神分裂症患者疗效相当,阿立哌唑在体重增加、锥体外系反应和泌乳、月经紊乱等方面的反应少于利培酮。     

Psychophysiologic responses of schizophrenics to drugs

Studies of psychophysiologic responses of schizophrenics to drugs have involved cardiovascular measures (heart rate, blood pressure, and finger pulse volume), electrical skin activity, digital temperature, pupillary response, muscle activity, and respiration. Drugs included phenothiazines and both sympathetic and parasympathetic agents. Effects of drugs were varied and complex and no simple conclusions are possible. Phenothiazines reduced generally elevated basal levels of psychophysiological activity of schizophrenics (except for heart rate) as well as their reactivity to stimuli. These changes were often accompanied by behavioral improvement, suggesting that schizophrenics can be characterized by excessive levels of arousal which are decreased by phenothiazines to more moderate levels. In contrast, Russian work indicated that the basal levels of schizophrenics are initially low and are generally elevated by drugs, including phenothiazines, with accompanying improvement in psychological functions. These diverse findings were interpreted as showing that the psychological functioning of schizophrenics is a nonmonotonic (inverted-U) function of psychophysiological arousal. A second hypothesis was proposed to account for nonphysiological (cognitive) deficits of schizophrenics, namely, that performance is a positive, monotonic function of attention. Consequently, a two-process theoretical model involving attention and arousal processes was proposed to account for schizophrenic behavior. Several methodological questions prevented clear interpretation of many drug findings. One particular problem involved possible effects from homeostatic restraint mechanisms (law of initial values or LIV effect). A technique for removal of LIV effects was described.Paper presented in part at the meetings of the American College of Neuropsychopharmacology, December 10–11, 1970, San Juan, Puerto Rico, as part of a symposium, Behavioral Mechanisms of Drug Action in Schizophrenia, Solomon C. Goldberg, Chairman.     

Effects of propranolol on cardiovascular and neuroendocrine responses to mental arithmetic in type A men

beta-Adrenergic hyperreactivity has been proposed as a pathogenic mechanism of increased coronary risk in Type A individuals. This study compared the effects of propranolol, diazepam, and placebo on cardiovascular and neuroendocrine responses to a stressful cognitive task in six young Type A males. Although diazepam did not differ from placebo, propranolol attenuated heart rate and norepinephrine responses and enhanced cortisol responses to the task. Findings suggest that propranolol has reciprocal effects on the norepinephrine and cortisol components of the "fight-flight" response. Possible central nervous system mechanisms are described.     

护理干预对首发精神分裂症患者疗效的影响

目的探讨护理干预对首发精神分裂症患者的疗效和社会功能康复的影响。方法选取80例在护理干预科病房住院治疗的首发精神分裂症患者为干预组,80例在非护理干预科病房住院的首发精神分裂症患者为对照组,对照组单用抗精神药物治疗,干预组在药物治疗的同时辅助心理和社会综合干预措施,于干预前,出院后随访6个月及1年末,采用自编一般资料调查表,阳性症状与阴性症状量表（PANSS）,社会功能缺陷筛选量表（SDSS）评定临床疗效及社会功能改善情况。结果PANSS评分出院后随防6月及1年末干预组总分及阴性症状分均显著低于对照组（P〈0.01）,SDSS评分出院后随访6个月及1年末干预组职业和工作、社会活动、家庭职能、生活自理、责任性和计划性等因素均显著低于对照组（P〈0.01）。结论护理干预措施有助于提高精神分裂症患者的疗效和促进社会功能的康复。     

Serotonin receptors and neuroendocrine responses

There is extensive pharmacologic evidence that serotonin receptors in the brain can activate the hypothalamic-pituitary-adrenocortical (HPA) axis in rats. Direct-acting serotonin agonists, serotonin uptake inhibitors, serotonin releasers and the serotonin precursor L-5-hydroxytryptophan all increase adrenocorticotrophin (ACTH) and corticosterone release. Serotonin-containing nerve terminals make synaptic contact with corticotrophin-releasing factor (CRF)-containing cells in rat hypothalamus, and serotonin and serotonin agonists stimulate CRF release from isolated rat hypothalamus in vitro. Current evidence, based partly on the ability of selective serotonin receptor antagonists to prevent the increases in ACTH and corticosterone in rats in vivo, implicates 5-HT1A and 5-HT2/5-HT1C receptor subtypes in regulating CRF secretion. The physiologic roles of serotonergic regulation of the HPA axis are not well understood. Serotonin neurons also appear to influence the secretion of other pituitary hormones, especially prolactin and gonadotropins.     

综合护理干预对首发精神分裂症患者疗效的影响

目的探讨护理干预对首发精神分裂症患者的疗效和社会功能康复的影响。方法选取80例在护理干预科病房住院治疗的首发精神分裂症患者为干预组,80例在非护理干预科病房住院的首发精神分裂症患者为对照组,对照组单用抗精神药物治疗,干预组在药物治疗的同时辅助心理和社会综合干预措施,于干预前,出院后随访6月和1年末,采用自编一般资料调查表,阳性症状与阴性症状量表（PANSS）,社会功能缺陷筛选量表（SDSS）评定临床疗效及社会功能改善情况。结果PANSS评分出院后随防6月及1年末干预组总分及阴性症状评分均显著低于对照组（P均（0.01）,SDSS评分出院后随访6月及1年末干预组职业和工作、社会活动、家庭职能、生活自理、责任性和计划性等因素均显著低于对照组（P均〈0.01）。结论护理干预措施有助于提高精神分裂症患者的疗效和促进社会功能的康复。