抗精神病药对男性精神分裂症患者性功能影响的相关性分析

目的 探讨抗精神病药喹硫平、利培酮、氯丙嗪及氯氮平对男性精神分裂症患者性功能影响的差异及相关因素分析.方法 将门诊就诊的男性精神分裂症患者120例,随机分为喹硫平组38例、利培酮组41例、氯丙嗪39例、氯氮平组42例.应用酶联免疫吸附法检测血清泌乳素、放射免疫法检测睾酮水平,检测各组患者治疗前及治疗第12周末的血清泌乳素(PRL)和睾酮水平.分别于基线及治疗第12周末使用简明男性性功能量表、阳性与阴性症状量表(PANSS)评估性功能及精神症状,于治疗第12周末用副反应量表(TESS)评估药物治疗的不良反应.结果 治疗第12周末,利培酮组、氯丙嗪组、氯氮平组的性功能量表总分较治疗前降低(P＜0.05).利培酮组和氯丙嗪组治疗第12周末的血清泌乳素水平高于基线水平利培酮组:(12±5)ng/ml,(22±6)ng/ml,t=13.92,P＜0.01；氯丙嗪组:(13±6)ng/ml,(19±5)ng/ml,t=8.27,P＜0.01],喹硫平组和氯氮平组无明显变化.利培酮组和氯丙嗪组治疗第12周末的血睾酮水平低于基线水平:利培酮组:(0.77±0.21)ng/ml,(0.27±0.11)ng/ml,t=13.22,P＜0.01;氯丙嗪组:(0.90±0.11)ng/ml,(0.32±0.14)ng/ml,t=11.27,P＜0.01;喹硫平组和氯氮平组无明显变化.影响男性精神分裂症患者性功能的因素有泌乳素、睾酮、年龄及TESS分.结论 抗精神病药物中,利培酮和氯丙嗪易引起血清泌乳素升高和血清睾酮降低,氯氮平具有较多药物不良反应,这些可能造成男性精神分裂症患者的性功能减退.

The effect of antipsychotics on sexual function in male patients with schizophrenia, a correlation analysis

Objective To investigate the differential effect of antipsychotics, quetiapine, risperidone,chlorpromazine, and clozapine, on male sexual function in schizophrenia patients, and explore their related factors. Methods 120 male outpatients with schizophrenia were randomly divided into quetiapine （n=38） ,risperidone（n=41） ,chlorpromazine（n= 39） and elozapine group （n= 42）. Enzyme linked immunosorbent assay was used for the detection of serum prolacti and radioimmunoassay for testosterone levels before and 12 wks after the treatments. Brief male sexual function scale, including the positive and negative symptom scale （ PANSS ）, and side reaction scale （ TESS ）were used to assess patient sexual function, psychiatric s ymptoms,nd treatment --induced adverse reactions at the 12th wk of treatment. Results After twelve weeks treatment, the sexual function scores of chlorpromazine group, clozapine group,risperidone group were decreased from those before treatment （P 〈 0.05）. The serum prolactin level of Risperidone and chlorpromazine group increased at the 12th week from baseline level ]risperidone group： （12±5）ng/ml, （22± 6）ng/ml, t ： 13.92 ,P 〈 0.01 ; chlorpromazine group： （13±6）ng/ml, （19± 5）ng/ml, t = 8.27,P〈 0.01]. quetiapine group and clozapine group showed no significant change. The 12 week blood testosterone levels of Risperidone group and chlorpromazine group decreased from baseline level risperidone group： （0. 77 ±0. 21） ng/ml, （0. 27 ± 0. 11） ng/ml t = 13.22,P 0.01）; chlorpromazinegroup： （ 0.90 ±0.11） ng/ml,（ 0. 32±0.14）ng/ml, t = 11.27,P〈 0.01], while quetiapine group and elozapine group showed no significant change. Conclusions antipsychotic drug risperidone and chlorpromazine can cause serum prolaetin elevation and serum testosterone reduction while Clozapine showed more adverse drug reactions. The results suggest that these antipsychotics may result in impaired sexual function in male schizophrenia patients.