齐拉西酮替换利培酮治疗缓解期女性精神分裂症患者药源性高催乳素血症的疗效

目的]了解齐拉西酮替换利培酮治疗存在药源性高催乳素血症的缓解期女性精神分裂症的可行性.方法]纳入148例正在服用利培酮、存在药源性高催乳素血症的缓解期女性精神分裂症患者.随机分配为齐拉西酮治疗组（A组）和利培酮对照组（B组）.A组原利培酮换为120～160 mg/d齐拉西酮治疗,B组继续利培酮治疗.2个月后复查血清催乳素水平,记录月经及泌乳的状况及阳性及阴性症状量表（PANSS）总评分.结果]A组月经紊乱及泌乳的发生率（17.8%）显著低于对照组（96%）（P〈0.01）.结论]齐拉西酮可以显著降低女性分裂症患者血清催乳素水平,显著改善利培酮导致的月经紊乱、泌乳等症状,但是可能同时会增加症状复燃及（或）复发的风险.

Efficacy of Ziprasidone Replacing Risperidone for the Treatment of Drug-induced Hyperprolactinemia in Female Patients with Schizophrenia in Remission

Objective] To understand the feasibility of ziprasidone replacing risperidone for the treatment of drug-induced hyperprolactinemia in female patients with schizophrenia in remission. Methods] Totally 148 female patients with schizophrenia and hyperprolactinemia who took risperidone were enrolled in this study. All patients were randomly divided into ziprasidone treatment group（group A） and risperidone control group （group B）. Group A turned to receive ziprasidone 120-160mg per day. Group B continued to take risperidone. Serum prolactin was reexamined after 2 months. Menstruation, lactation and total scores of positive and negative PANSS were recorded after 2 months. Results] The prevalence of menstrual disorder and lactation in group A（17.8%） was significantly lower than that in control group（96%）（ P〈0.01）. Serum prolactin in group A（474.09±70.18 1U/mL） was markedly lower than that in control group（607,32±50.90 IU/mL）, and total PANSS scores in group A（49.66 ±17.95） were markedly higher than those in control group（36.21± 0.92）, and there were significant differences（ P 〈0.01）. Conclusion] Ziprasidone replacing risperidone can significantly decrease serum prolactin in female patients with schizophrenia and improve menstrual disorder and lactation caused by risperidone, but it may increase the risk of recurrence.