抗精神病药对男性精神分裂症患者性功能与催乳素的影响

目的：探讨抗精神病药（APS）对恢复期精神分裂症患者性功能影响及其与催乳素相关性。方法：入组以氯丙嗪、氯氮平和利培酮单一治疗至少6个月各60例、具有稳定配偶的恢复期精神分裂症男性患者。以亚利桑那洲性经验量表（ASEX）进行总体性功能障碍（SD）评定,放免法检测血浆催乳素水平。结果：①氯丙嗪组ASEX总分以及5个分因子分均显著高于氯氮平组和利培酮组（P〈0.05或P〈0.001）,氯丙嗪组SD发生率也显著高于其他两组（P均〈0.05）。②利醅酮组血浆催乳素显著高于氯丙嗪组和氯氮平组（P均〈0.001）,血浆催乳素水平与全体患者（P=0.007）和利培酮组患者（P=0.006）ASEX总分呈显著正相关。结论：氯丙嗪较氯氮平和利培酮更易于发生SD,利培酮可能导致催乳素水平增高。

The influence of antipsychotics treatment on sexual function in remitted male schizophrenic patients and the correlation with plasma prolactin concentrations

Objective：To determine the influence of antipsychotics treatment on sexual function in remitted male schizophrenia and to assess the possible role of plasma prolactin concentrations. Method：The male schizophrenic patients,who were meeting criteria for remission,living with a sexual partner and receiving antipsychotic drug monotherapy （ chlorpromazine,clozapine and risperidone,n = 60 respectively） for at least six months were recruited. Sexual dysfunction was assessed using the Arizona sexual experience scale （ ASEX）. Blood samples were taken for plasma prolactin determination by double antibody radioimmunoassay （ RIA）. Results：①The ASEX score and its 5 items were significantly higher in the patients receiving chlorpromazine than those receiving risperidone or clozapine （ P 0. 05 or P 0. 001）. The frequency of sexual dysfunction was also greater in chlorpromazine group than risperidone or clozapine groups （ both P 0. 05）. ②Prolactin was significantly higher in subjects receiving risperidone compared with those receiving clozapine or chlorpromazine （ both P 0.001）. Prolactin was significantly correlated with ASEX score within the whole patients （ P =0. 007） and the risperidone （ P = 0. 006） group. Conclusion：Chlorpromazine are more likely to be associated with sexual dysfunction in men than the atypical drugs. Risperidone might increase blood prolactin.