氯氮平,氟哌啶醇对精神分裂症患者血清催乳素的影响

本文对１６例服用氯氮平、氟哌啶醇的精神分裂症患者血清催乳素（ＰＲＬ）浓度进行测定分析。结果：氟哌啶醇组的血清ＰＲＬ浓度（Ｘ↑－＝３２．９μｇ／Ｌ）与治疗前相比有明显增高；氯氮平组的ＰＲＬ浓度（Ｘ↑－＝７．０１μｇ／Ｌ）与治疗前无显著差异。提示氯氮平与氟哌啶醇对多巴胺的影响不同。     

氟哌啶醇对精神分裂症超氧化物歧化酶的作用

目的：探讨精神分裂症自由基代谢酶超氧化物歧化酶（ＳＯＤ）在氟哌啶醇治疗前后的变化。方法：用固定剂量氟哌啶醇治疗４６例慢性精神分裂症患者１２周，在治疗前后应用放射免疫法测定血ＳＯＤ含量，并评定ＢＰＲＳ、ＳＡＰＳ和ＳＡＮＳ量表。结果：治疗前ＳＯＤ值与ＳＡＰＳ总分正相关（Ｐ〈０．０５）。治疗后，治疗前高ＳＯＤ组明显降低，而低ＳＯＤ组明显增高（Ｐ均〈０．０５）。阴性型亚组中，治疗前ＳＯＤ值与治疗前后ＳＡＮ     

氟哌啶醇对精神分裂症细胞免疫功能的影响

目的：探讨氟哌啶醇对精神分裂症细胞免疫功能的影响。方法：将入组病人用氟哌啶醇进行为期12周的治疗,治疗前、后测定T淋巴细胞亚群CD3、CD4、CD8阳性细胞数和红细胞免疫功能C3b花环率（RBC－C3b)及红细胞免疫复合物花环率（RBC－IC）。结果：疗前CD3,CD4,CD8,RBC－IC明显低于对照组;疗后CD3,CD4,CD4／CD8比值、RBC－C3b明显升高,CD8、RBC－IC明显降低。结论：氟哌啶醇对精神分裂症细胞免疫功能有明显影响。     

利培酮与氟哌啶醇对女性首发精神分裂症患者血清催乳素水平的影响

目的探讨女性首发精神分裂症患者血清催乳素(PRL)水平,利培酮与氟哌啶醇对PRL水平的影响,以及PRL水平与疗效的关系.方法用酶联免疫法测定66例女性首发精神分裂症患者利培酮与氟哌啶醇治疗前后的PRL水平,与25名正常人对照,并在治疗前后进行阳性和阴性症状量表(PANSS)评定.结果女性首发精神分裂症患者的基础PRL水平与正常对照组无差异;两组患者治疗后血清PRL水平较治疗前显著升高,但两组比较无明显差异;两组患者基础PRL水平与患者年龄、病程、基线PANSS总分及各因子分无明显相关性,与治疗后PANSS总分及各因子分无明显相关性.两组患者PRL增加值与PANSS减分值和各因子减分、药物剂量无明显相关性.结论利培酮和氟哌啶醇都能使女性首发精神分裂症患者PRL水平显著升高,但PRL水平与疾病严重程度及疗效无关.     

氟哌啶醇快速治疗精神分裂症及护理

氟哌啶醇对精神分裂症的疗效肯定,对控制急性兴奋躁动及紊乱性行为,效果更为显著,其快速疗法值得推广。但在临床使用中,应利弊兼顾,加强护理,防范意外。现结合几例典型病例,对快速治疗的护理讨论于下。     

氟哌啶醇癸酸酯治疗慢性精神分裂症的对照观察

对氟哌啶醇癸酸酯（ＨＰ）和氯丙嗪（ＣＰＺ）治疗慢性精神分裂症进行对照观察，发现两组总有效率虽无显著性差异，但是显效率ＨＰ组明高于氯丙嗪（ＣＰＺ）组（ｘ＾２＝４．０６ Ｐ〈０．０５）。ＨＰ对ＢＰＲＳ各项因子及总分的疗效也均优于ＣＰＺ组。提示ＨＰ对精神分裂症有良好的效果，是防止慢性精神分裂症复发，长期维持巩因治疗比较理想的药物。     

Abnormal prolactin response to haloperidol challenge in men with schizophrenia

Fourteen drug-free male patients with schizophrenia had a smaller and slower prolactin response to 0.5 mg of intravenous haloperidol than 14 normal age- and sex-matched control subjects. This finding supports the presence of dopaminergic dysfunction in schizophrenia.     

氟哌啶醇癸酸酯维持治疗阴阳性症状的对照研究

本文报告５个机构合作研究的结果。随机分层抽取社区中精神分裂症患者，进行一年前瞻性抗精神病药物治疗的对照研究，共２９２例，内氟哌啶醇癸酸酯（ＨＤ）治疗１５５例（ＨＤ组），原药维持１３７例（对照组）。结果显示ＨＤ维持治疗对阴性和阳性症状的有效率为６３～８００％，阴／阳性症状有效率为６６％。ＢＰＲＳ量表各国子分６个月和１２个月无显著差异．但ＳＡＮＳ量表各因子分１２个月比６个月有时明显进步。ＨＤ对阴性症状、ＢＰＲＳ量表因子Ⅱ、Ⅲ、Ⅴ和ＳＡＮＳ量表各因子的疗效均优于对照组。     

长期住院男性精神分裂症患者血清催乳素水平调查

目的:调查长期住院服用典型抗精神病药的男性精神分裂症患者血清催乳素(PRL)水平。方法:114例长期住院的男性精神分裂症患者(患者组)使用电化学发光免疫分析技术检测血清PRL水平,并与性别、年龄相匹配的57名正常男性(对照组)相比较。结果:患者组的血清PRL水平平均(24.1±18.8)ng/ml显著高于对照组(10.6±5.5)ng/ml(t=7.06,P<0.01)。患者组中吸烟精神分裂症患者血清PRL水平平均(21.2±15.4)ng/ml显著低于非吸烟精神分裂症患者(30.7±23.9)ng/ml(t=-2.17,P<0.05)。精神分裂症患者血清PRL水平与患者年龄(r=0.003)、服药剂量(折算为氯丙嗪,r=-0.12)、服药时间(r=-0.18)以及体质量指数(r=-0.07)之间无明显相关性(P均>0.05)。结论:长期服用典型抗精神病药可显著增高男性精神分裂症患者血清PRL水平,吸烟对血清PRL水平有一定的影响。     

Clinical response and plasma haloperidol levels in chronic and subchronic schizophrenia

Levels of haloperidol were determined by radioimmunoassay (RIA) in 30 schizophrenic patients (diagnosed according to the criteria of DSM-III), who were treated with fixed doses of this neuroleptic for a period of 21 days. An inverted U-shaped relationship was found between the percent improvement observed in the BPRS global score and the steady state of haloperidol. The interval of effective concentration of haloperidol was set between 12.0 and 35.5 ng/ml. However, the limits of such an interval found in the subchronic schizophrenic subgroup (SS) ranged from 7.4 to 24.9 ng/ml, whereas in the chronic schizophrenic subgroup (CS), it ranged from 14.8 to 38.5 ng/ml. This finding suggests that the interval of effective concentrations may vary as a function of the number of years of evolution of the subjects' illness. This may be compatible with the development of tolerance in the mesolimbic and/or mesocortical dopaminergic systems as a response to prolonged neuroleptic treatments.     

Effects of chronic haloperidol and clozapine treatments on frontal and caudate neurochemistry in schizophrenia

N-Acetyl-aspartate (NAA), a marker of neuronal integrity, has been found to be reduced in frontal regions in schizophrenia. However, the impact of antipsychotic drug type on NAA has not been carefully evaluated. We studied outpatients with schizophrenia/schizoaffective disorders chronically treated with haloperidol or clozapine and normal controls with single-voxel 1H-MRS of the caudate nuclei and the left frontal lobe. Concentrations of NAA, choline containing compounds (Cho) and creatine plus phosphocreatine (Cre) were determined and corrected for the proportion of cerebrospinal fluid (CSF) in each voxel. The haloperidol-treated group had significantly lower CSF-uncorrected and CSF-corrected left frontal NAA than the normal controls, with the clozapine group having intermediate concentrations. The haloperidol-treated group had significantly lower CSF-uncorrected caudate NAA than the normal controls, but the three groups did not differ after correcting for CSF fraction. Performance times in the Grooved Pegboard, a measure of motor dexterity and proxy for parkinsonism, were correlated with CSF-uncorrected and CSF-corrected left frontal NAA. Demographic and illness-related variables were not related to NAA. Exposure to haloperidol-like drugs may in part account for the frontal NAA reductions previously reported in schizophrenia. Adjustment for proportion of voxel CSF should be considered in 1H-MRS studies.     

Olanzapine vs. haloperidol in the treatment of elderly chronic schizophrenia patients

OBJECTIVE: Most of the data supporting the use of atypical antipsychotics (AA) is based on studies in young adult patients. The present study is an open-label naturalistic follow-up study of olanzapine treatment vs. haloperidol for elderly chronic schizophrenia patients. MEHTOD: 20 patients (mean age 72.7+/-5.9 years, mean disease duration 33.1+/-12.0 years) who met the DSM-IV criteria for schizophrenia were randomly assigned to olanzapine (n=10) or haloperidol (n=10) treatment during acute exacerbation. Primary outcome measure was rating on the Clinical Global Impression (CGI) scale and the Positive and Negative Symptom Scale (PANSS). RESULTS: Between-group differences were computed using analysis of covariance. PANSS Total score decreased from 84 at baseline to 65 after treatment with olanzapine while decreased only from 79 to 74 with haloperidol treatment (F= 6.66, P=.02). PANSS Negative subscale decreased from 19 at baseline to 15 with olanzapine treatment while increased (deteriorated) from 18 to 20 with haloperidol treatment (F=23.37, P=.0003). CGI decreased from baseline with both olanzapine and haloperidol treatments (1.1 vs. 0.4) but the decrease in the olanzapine group was significantly greater (F=4.63, P=.05). Mean weight increased in both groups but without statistical difference between groups. CONCLUSIONS: In elderly chronic schizophrenia patients, olanzapine treatment is superior to haloperidol in reducing negative symptoms as well as less induction of extrapyramidal symptoms (EPS).     

利培酮对慢性精神分裂症泌乳素的影响

目的探讨非典型抗精神病药利培酮对泌乳素的影响及其与临床疗效的关系。方法采用固定剂量利培酮（６ｍｇ／ｄ）治疗慢性、男性精神分裂症３０例,疗程１２周;在治疗前后评定ＰＡＮＳＳ量表,并用放射免疫法测查血浆中泌乳素（ＰＲＬ）浓度。以１６例健康人为对照。结果治疗后,患者ＰＡＮＳＳ总分及其分量表均显著降低;治疗前患者ＰＲＬ较对照组显著降低,治疗后显著性增高。治疗前后泌乳素差值与ＰＡＮＳＳ阳性症状分量表减分值、减分率显著相关。结论利培酮对精神分裂症血泌乳素水平有明显影响,而且泌乳素水平与临床疗效相关。