中华精神科杂志
中華精神科雜誌
중화정신과잡지
CHINESE JOURNA OF PSYCHIATRY
2011年
3期
151-154
,共4页
陈海支%钱敏才%沈鑫华%杨胜良%沈仲夏%宋娟芬%杨剑虹%那万秋%宋宝华%费小聪%任丽华%夏青春
陳海支%錢敏纔%瀋鑫華%楊勝良%瀋仲夏%宋娟芬%楊劍虹%那萬鞦%宋寶華%費小聰%任麗華%夏青春
진해지%전민재%침흠화%양성량%침중하%송연분%양검홍%나만추%송보화%비소총%임려화%하청춘
精神分裂症%雌二醇%催乳素%月经失调%利哌立酮
精神分裂癥%雌二醇%催乳素%月經失調%利哌立酮
정신분렬증%자이순%최유소%월경실조%리고립동
Schizophrenia%Estradiol%Prolactin%Menstrual disorder%Risperidon
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周末检测血清生殖激素含量,并使用阳性与阴性症状量表(PANSS)对精神症状进行评定,将所得数值进行单因素及多因素非条件Logistic回归分析.结果 (1)治疗前,研究组雌二醇(E2)含量[(245.42±185.81)pmol/L]低于对照组[(344.39±201.08)pmol/L],差异有统计学意义(t=2.03,P=0.047);治疗第8周末,研究组和对照组催乳素含量[(81.94±42.19)、(82.50±40.77)nmol/L]高于治疗前[(23.11±8.11)、(20.49±8.89)nmol/L],差异有统计学意义(t=7.42、P=0.000,t=7.99、P=0.000),E2含量[(133.39±122.17)、(199.00±168.49)pmol/L]低于治疗前[(245.42±185.81)、(344.39±201.08)pmol/L],差异有统计学意义(t=2.82、P=0.009,t=3.14、P=0.004),对照组孕激素含量[(3.51±5.45)nmol/L]低于治疗前[(13.17±15.69)nmol/L],差异有统计学意义(t=3.45,P=0.002);其他各项指标治疗前后组内及组间比较差异无统计学意义(P均>0.05).(2)治疗前1 d和治疗第8周末,2组PANSS总分及分量表评分明显下降,组内比较差异有统计学意义(P均<0.01);组问比较差异无统计学意义(P>0.05).(3)Logistic回归分析显示,雌激素水平是月经延迟的危险冈素(P=0.047).结论 精神分裂症患者基础雌激素水平低是服用利培酮出现月经延迟的危险因素之一.
目的 探討服用利培酮精神分裂癥患者齣現月經延遲的危險因素及可能機製.方法 採用前瞻性巢式病例-對照研究設計,將未接受抗精神病藥治療、符閤中國精神疾病分類與診斷標準第3版精神分裂癥診斷標準、常規服用利培酮治療8週後齣現月經延遲>4週的31例患者(研究組)和月經仍然規律的32例患者(對照組),于治療前1 d和治療第8週末檢測血清生殖激素含量,併使用暘性與陰性癥狀量錶(PANSS)對精神癥狀進行評定,將所得數值進行單因素及多因素非條件Logistic迴歸分析.結果 (1)治療前,研究組雌二醇(E2)含量[(245.42±185.81)pmol/L]低于對照組[(344.39±201.08)pmol/L],差異有統計學意義(t=2.03,P=0.047);治療第8週末,研究組和對照組催乳素含量[(81.94±42.19)、(82.50±40.77)nmol/L]高于治療前[(23.11±8.11)、(20.49±8.89)nmol/L],差異有統計學意義(t=7.42、P=0.000,t=7.99、P=0.000),E2含量[(133.39±122.17)、(199.00±168.49)pmol/L]低于治療前[(245.42±185.81)、(344.39±201.08)pmol/L],差異有統計學意義(t=2.82、P=0.009,t=3.14、P=0.004),對照組孕激素含量[(3.51±5.45)nmol/L]低于治療前[(13.17±15.69)nmol/L],差異有統計學意義(t=3.45,P=0.002);其他各項指標治療前後組內及組間比較差異無統計學意義(P均>0.05).(2)治療前1 d和治療第8週末,2組PANSS總分及分量錶評分明顯下降,組內比較差異有統計學意義(P均<0.01);組問比較差異無統計學意義(P>0.05).(3)Logistic迴歸分析顯示,雌激素水平是月經延遲的危險岡素(P=0.047).結論 精神分裂癥患者基礎雌激素水平低是服用利培酮齣現月經延遲的危險因素之一.
목적 탐토복용리배동정신분렬증환자출현월경연지적위험인소급가능궤제.방법 채용전첨성소식병례-대조연구설계,장미접수항정신병약치료、부합중국정신질병분류여진단표준제3판정신분렬증진단표준、상규복용리배동치료8주후출현월경연지>4주적31례환자(연구조)화월경잉연규률적32례환자(대조조),우치료전1 d화치료제8주말검측혈청생식격소함량,병사용양성여음성증상량표(PANSS)대정신증상진행평정,장소득수치진행단인소급다인소비조건Logistic회귀분석.결과 (1)치료전,연구조자이순(E2)함량[(245.42±185.81)pmol/L]저우대조조[(344.39±201.08)pmol/L],차이유통계학의의(t=2.03,P=0.047);치료제8주말,연구조화대조조최유소함량[(81.94±42.19)、(82.50±40.77)nmol/L]고우치료전[(23.11±8.11)、(20.49±8.89)nmol/L],차이유통계학의의(t=7.42、P=0.000,t=7.99、P=0.000),E2함량[(133.39±122.17)、(199.00±168.49)pmol/L]저우치료전[(245.42±185.81)、(344.39±201.08)pmol/L],차이유통계학의의(t=2.82、P=0.009,t=3.14、P=0.004),대조조잉격소함량[(3.51±5.45)nmol/L]저우치료전[(13.17±15.69)nmol/L],차이유통계학의의(t=3.45,P=0.002);기타각항지표치료전후조내급조간비교차이무통계학의의(P균>0.05).(2)치료전1 d화치료제8주말,2조PANSS총분급분량표평분명현하강,조내비교차이유통계학의의(P균<0.01);조문비교차이무통계학의의(P>0.05).(3)Logistic회귀분석현시,자격소수평시월경연지적위험강소(P=0.047).결론 정신분렬증환자기출자격소수평저시복용리배동출현월경연지적위험인소지일.
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.
