阿立哌唑与利培酮对血清催乳素水平影响的对照研究

目的:比较阿立哌唑和利培酮对精神分裂症患者的血清催乳素(PRL)的影响及其与临床疗效的关系。方法:将70例精神分裂症急性发作的患者随机分为阿立哌唑组(n=35)和利培酮组(n=35),观察疗程8周。在治疗前及治疗后第2、4、8周末采用阳性阴性症状量表(PANSS)进行评定,并于治疗前、中、后采用磁酶免疫法检测血清催乳素(PRL)的水平。结果:两组PANSS减分率分别为阿立哌唑组(47.21±13.34)%、利培酮组(46.78±14.13)%,临床有效率分别为88.57%、88.57%,治疗前、后阿立哌唑组PRL水平比较差异无显著性(P>0.05),利培酮组PRL明显增高(P<0.05)。阿立哌唑组治疗前、后PRL水平的差值与PANSS减分率经相关分析差异有显著性(P<0.05),而利培酮组差异则无显著性(P>0.05)。出现月经紊乱或泌乳阿立哌唑组(1/16,6.25%)较利培酮组(8/17,47.06%)明显为少(P<0.05)。结论:两种药对精神分裂症疗效均较显著,阿立哌唑对PRL水平影响很少,利培酮则影响较大,与疗效无明显关系。

A Comparative Study of Effect on Serum Prolactin Level between Aripiprazole and Risperidone

Objective:To compare the effect on serum prolactin level and its relationship with clinical efficacy between aripiprazole and risperidone treatment in schizophrenia.Methods:70 patients with CCMD-3 schizophrenia were randomized into aripiprazole(n=35) and risperidone(n=35) treatment in a 8-week parallel-group study.The two groups demonstrated a significant decrease in PANSS score(P<0.05) at the end of 2nd 4th and 8th week of treatment.The prolactin level was measured by chemiluminescenct assay before,during and after treatment.Results:The reduction of total scores of PANSS and the rate of clinical response were(47.21±13.34)% and 88.57% in aripiprazole group,(46.78±14.13)% and 88.57% in risperidone group,respectively.There was no significant difference in serum level of PRL before and after treatment in aripiprazole group.However,the serum level of PRL increased highly after risperidone treatment(P<0.05).There was a significant relationship between the dispersion of serum PRL level and the reduction of total PANSS score in aripiprazole group between before and after treatment(P<0.05);however,not in risperidone group(P>0.05).Compared with patients in risperidone group(8/17,47.06%),patients in aripiprazole group(1/16,6.25%) seldom had menstruation dysfunction and lactation(P<0.05).Conclusion:Aripiprazole is as effective as risperidone in the treatment of patients with schizophrenia,with less influence on serum PRL level,which differentiate from risperidone and has no relationship with clinical efficacy.