生殖激素水平对女性精神分裂症患者利培酮所致月经延迟的影响

目的 探讨服用利培酮精神分裂症患者出现月经延迟的危险因素及可能机制.方法 采用前瞻性巢式病例-对照研究设计,将未接受抗精神病药治疗、符合中国精神疾病分类与诊断标准第3版精神分裂症诊断标准、常规服用利培酮治疗8周后出现月经延迟>4周的31例患者(研究组)和月经仍然规律的32例患者(对照组),于治疗前1 d和治疗第8周末检...

The effect of reproductive hormone level on delayed menses induced by risperidone in schizophrenic patients

Objective To explore the possible role of the reproductive hormone in the mechanisms of female delayed menses induced by risperidone in schizophrenic patients. Methods In this prospective nested case-control study, 63 female schizophrenic patients who never received antipsychotic drug were involved. After treated with risperidone for 8 weeks, 31 cases' menses cycle were delayed>4 weeks (the research group) , while 32 cases remained regular (the control group). The reproductive hormone level was detected at the beginning of the treatment and after 8 week therapy. The PANSS was applied to evaluate the psychotic symptoms through the treatment Results The estradiol (E2) level in the research group [(245. 42 ±185. 81) pmol/L] was lower than the control group[(344. 39 ±201. 08) pmol/L] before the treatment (P = 0. 047) , and the prolactin (PRL) levels in both group [(81. 94 ± 42. 19) , (82. 50 ±40. 77) nmol/L] after treatment are higher than that before the treatment [(23. 11 ± 8. 11) , (20. 49 ±8. 89) nmol/L] (Ps <0.001). The E2 levels in both group [(133. 39 ± 122. 17), (199.00 ± 168.49) pmol/L] were lower than that [(245. 42 ± 185. 81) , (344. 39 ± 201. 08) pmol/L] before the treatment (Ps <0. 01) , and the progestin level in the control group [(3. 51 ±5. 45) nmol/L] decreased significantly compared to that before the treatment [(13. 17 ± 15. 69) nmol/L] (P = 0.002). The PANSS total score decreased significantly after the treatment in both group (P<0. 01) , with no difference between the two group (P>0. 05) . Logistic regression analysis indicated that the estrogen level was the risk factor of delayed menses (P = 0. 047). Conclusion The low E2 level at the baseline may be one of the risk factors of female menses delay induced by risperidone in schizophrenic patients.