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。

Study of risperidone on efficacy and plasma prolactin level in first-episode schizophrenia

Objective To investigate the effect of atypical antipsychotic drug risperidone on the plasma prolactin level and their relationship with clinical efficacy. Methods Thirty patients who met the criteria of CCMD-III for schizophrenia and 30 matched normal controls were enrolled in the study. All patients received 12-week treatment of risperidone. Positive and negative symptoms scale (PANSS) was used to assess the psychopathology before and after the treatment. Blood samples were collected at the beginning and end of treatment and plasma prolactin was detected by radioimmunoassay(RIA). Results The total score and sub-scoreb of PANSS before and after the treatment had significant difference. The patients with high level of prolactin before the treatment or with a larger increase of prolactin had better efficacy, especially the improvement of the positive symptoms. Conclusion Risperdone increase the plasma prolactin level significantly. The changes of plasma prolactin level are correlated with treatment efficacy, especially the improvement of positive symptoms.