【摘要】 目的:探讨小剂量阿立哌唑治疗第2代抗精神病药(SGAs)所致高催乳素血症(HPL)的长期疗效及安全性。方法:40例单用SGAs治疗4周后出现HPL的精神分裂症女性患者,随机分为干预组及对照组各20例,均维持原有治疗方案不变,干预组加用阿立哌唑5 mg/d,疗程24周。于基线、进入研究第4、8、16、24周末分别检测血清催乳素和雌二醇水平,采用阳性和阴性症状量表(PANSS)及治疗中出现的症状量表(TESS)评估疗效及安全性。结果:干预组16例和对照组15例完成研究。治疗结束时,干预组催乳素水平较基线下降(F=12. 24,df=1. 74,P <0. 001),对照组催乳素水平较基线上升(F=5. 88,df=1. 60,P=0. 010),两组间比较差异有统计学意义(F=12. 91,df=1. 68,P <0. 001);干预组雌二醇水平较基线上升(F=4. 20,df=2. 46,P=0. 017),对照组雌二醇水平较基线下降但未达到统计学意义(F=2. 94,df=1. 73,P=0. 071),两组间比较差异有统计学意义(F=8. 22,df=2. 43,P <0. 001)。治疗后两组PANSS总分较基线显著下降,但组间比较差异无统计学意义(F=1. 19,df=1. 59,P=0. 304)。干预组40%患者催乳素水平恢复至正常范围,对照组无。干预组锥体外系不良反应(EPS)发生率低于对照组(50%vs. 90%,P <0. 01)。结论:阿立哌唑5 mg/d联合治疗SGAs所致HPL的女性精神分裂症患者,可有效降低催乳素水平和减少EPS的发生。更多还原

【Abstract】 Objective: To explore the long efficacy and safety of a low dose aripiprazole(5 mg/d) adjunctive treatment for female schizophrenia with hyperprolactinemia(HPL) induced by the second generation antipsychotics(SGAs). Method: Forty schizophrenic female patients with HPL induced by the 4 weeks monothearpy with SGAs were randomly assigned to the treatment group(aripiprazole 5 mg/d adjunctive treatment)(n = 20)and the control group(non-adjunctive treatment)(n = 20) for 24 weeks. At baseline and the end of the 4 th,8 th,16 th and 24 th week,the prolactin(PRL) level and the estradiol level were measured,the positive and negative syndrome scale(PANSS) and treatment emergent symptom scale(TESS) were assessed. Results: Sixteen patients in the treatment group and 15 patients in the control group completed the study. The PRL level at the end of the 24 th week was significantly reduced compared with that at baseline in the treatment group(F = 12. 24,df = 1. 74,P < 0. 001) and increased significantly in the control group(F = 5. 88,df = 1. 60,P = 0. 010),there was a significant difference between two groups(F = 12. 91,df = 1. 68,P < 0. 001). The estradiol level at the end of 24 th week was increased significantly compared with that at baseline in the treatment group(F = 4. 20,df = 2. 46,P = 0. 017) and not significantly reduced in the control group(F = 2. 94,df = 1. 73,P = 0. 071),there was a significant difference between two groups(F = 8. 22,df = 2. 43,P < 0. 001). The total score of PANSS was significantly reduced in both groups,and there was not a significant difference between the two groups(F =1. 19,df = 1. 59,P = 0. 304). In the treatment group,40% patients got the normal PRL level,while in the control group no patient got the normal PRL level. Extrapyramidal symptoms(EPS) were less in the treatment group compared with the control group(50% vs. 90%,P < 0. 01). Conclusion: For female schizophrenia with HPL induced by SGAs,a low dose aripiprazole(5 mg/d) adjunctive treatment can reduce PRL and EPS.更多还原