青少年男女精神分裂症患者利培酮治疗后血药浓度与血清催乳素的比较

目的 比较男女青少年精神分裂症患者服用利培酮后利培酮、9-羟利培酮血药浓度和血清催乳素,并探讨血药浓度与血清催乳素的关系. 方法 符合DSM-V诊断标准的精神分裂症青少年患者41例(男20例,女21例),给予利培酮治疗8周.在治疗基线和第4,8周末测定血清催乳素水平,在治疗第4,8周末监测利培酮和9-羟利培酮的血药浓度. 结果 ①血清催乳素在时间上存在主效应(P＜0.001),其中第4周末、第8周末男、女患者血清催乳素水平分别与基线进行自身比较,差异有统计学意义(P＜0.001)；②男、女患者间血药浓度和血清催乳素水平在第4周末、第8周末进行比较,无统计学差异(P＞0.05).③男、女患者利培酮(Ris)、9-羟利培酮(9oh)血药浓度与血清催乳素存在正相关(男:4周末PRis＜0.01、P9oh＜0.01;8周末PRis＜0.01、P9oh ＜0.05;女:4周末PRis＞0.05、P9oh ＜0.01,8周末PRis＜0.05、P9oh＜0.01). 结论 ①利培酮能明显升高青少年患者血清催乳素水平；其血药浓度越高,催乳素水平也越高；②性别对血药浓度和血清催乳素水平无影响.

Comparison of plasma concentration of risperidone and serum prolactin level after risperidone treatment between male and female adolescents with schizophrenia

Objective To compare the plasma concentrations of risperidone,9-hydroxyrisperidone and serum prolactin levels after risperidone treatment between the male and female adolescents with schizophrenia,and to explore their relations.Methods A total of 41 patients(20 male and 21 female)met the DSM-IV criteria for schizophrenia.The patients were given risperidone for 8 weeks.Serum prolactin,plasma concentrations of risperidone and 9-hydroxyrisperidone were obtained at the baseline,at the end of 4th and 8th week.Results ①Serum prolactin had a significant main effect on the time of taking medicine(P<0.001).Compared with the baseline,both male and female showed statistical difference in serum prolactin at the end of 4th and 8th week(P<0.001).②There was no statistical deference between male and female in plasma concentration and serum prolactin(P>0.05).③In the male and female,serum prolactin was positively correlated with plasma concentration of risperidone(Ris)and 9-hydroxyrisperidone(9oh)(male:at the end of 4th week PRis<0.01 and P9oh<0.01,at the end of 8th week PRis <0.01 and P 9oh<0.05;female:at the end of 4th week PRis>0.05 and P9oh<0.01;at the end of 8th week PRis<0.05 and P9oh<0.01).Conclusion ①Risperidone could significantly increase serum prolactin levels of the adolescents with schizophrenia.The higher the plasma concentration of resperidone is,the higher the prolactin level is.②The sex has no effect on the plasma concentrations of risperidone and serum prolactin in adolescents with schizophrenia.