CAJ | 학술논문

背景：血清催乳素升高和体重增加是非典型抗精神病药物常见的副作用，但很少有研究评估这些副作用的长期情况。 　　目标：比较利培酮或喹硫平治疗女性首发精神分裂症患者12个月后对血清催乳素及体重变化的影响。 　　方法：80例女性首发精神分裂症住院患者被随机分配接受利培酮（N=40）或喹硫平（N=40）为期12个月的治疗。在开始治疗前一天和开始治疗后第1，3，6，9和12个月分别进行催乳素浓度，体重和身高的测定。在每一个时间段同时采用阳性和阴性症状量表（PANSS）评估症状的严重程度。 　　结果：利培酮组31例患者和喹硫平组33例患者完成12个月的治疗。两组PANSS评分在每次后续的评估中都有所下降；利培酮组在治疗3个月和6个月时的改善显著，但在治疗第9个月两组的水平改善相似。喹硫平组血清催乳素在12个月内保持稳定，但利培酮组的血清催乳素水平在一年的随访中升高3.5至5.2倍。两组均出现体重增加，特别是在治疗的头3个月：两组的体重指数在治疗3个月时增加了62％。体重变化组间没有显著差异。体重变化和催乳激素水平变化之间的相关性呈弱阳性：利培酮组rs=0.17（p=0.104），喹硫平组r=0.07（p=0.862）。 　　结论：虽然利培酮更迅速有效，但利培酮和喹硫平在治疗首发精神分裂症的第一年有相似的疗效。慢性高泌乳素血症与利培酮使用有关，但喹硫平没有。长期服用这两种药物与体重持续增加有关；两种药物在体重增加的时间性和幅度上相似。体重增加和催乳素水平变化不是密切相关的。
배경：혈청최유소승고화체중증가시비전형항정신병약물상견적부작용，단흔소유연구평고저사부작용적장기정황。 　　목표：비교리배동혹규류평치료녀성수발정신분렬증환자12개월후대혈청최유소급체중변화적영향。 　　방법：80례녀성수발정신분렬증주원환자피수궤분배접수리배동（N=40）혹규류평（N=40）위기12개월적치료。재개시치료전일천화개시치료후제1，3，6，9화12개월분별진행최유소농도，체중화신고적측정。재매일개시간단동시채용양성화음성증상량표（PANSS）평고증상적엄중정도。 　　결과：리배동조31례환자화규류평조33례환자완성12개월적치료。량조PANSS평분재매차후속적평고중도유소하강；리배동조재치료3개월화6개월시적개선현저，단재치료제9개월량조적수평개선상사。규류평조혈청최유소재12개월내보지은정，단리배동조적혈청최유소수평재일년적수방중승고3.5지5.2배。량조균출현체중증가，특별시재치료적두3개월：량조적체중지수재치료3개월시증가료62％。체중변화조간몰유현저차이。체중변화화최유격소수평변화지간적상관성정약양성：리배동조rs=0.17（p=0.104），규류평조r=0.07（p=0.862）。 　　결론：수연리배동경신속유효，단리배동화규류평재치료수발정신분렬증적제일년유상사적료효。만성고비유소혈증여리배동사용유관，단규류평몰유。장기복용저량충약물여체중지속증가유관；량충약물재체중증가적시간성화폭도상상사。체중증가화최유소수평변화불시밀절상관적。
Background:Increased serum prolacitn and weight gain are common side effects of atypical anitpsychoitcs but few studies have assessed the long-term pattern of these adverse effects. Aim:Compare the effects of risperidone and queitapine on serum prolacitn and weight over 12 months of treatment among female paitents with ifrst-episode schizophrenia. Methods:Eighty female inpatients with first-episode schizophrenia were randomly assigned to receive risperidone (n=40) or quetiapine (n=40) for 12 months. Prolactin concentration, weight and height were measured one day before staritng treatment and 1, 3, 6, 9 and 12 months atfer iniitaitng treatment. Severity of symptoms was assessed at the same time periods using the Positive and Negative Syndrome Scale (PANSS). Results:Thirty-one patients in the risperidone group and 33 patients in the quetiapine group completed the 12 months of treatment. PANSS scores decreased at each follow-up assessment for both groups;the improvement was signiifcantly greater in the risperidone group atfer 3 months and 6 months of treatment but by the 9th month of treatment the level of improvement in the two groups was similar. In the queitapine group serum prolacitn remained stable throughout the 12 months but in the risperidone group the serum prolacitn level increased 3.5-to 5.2-fold over the one-year follow-up. Weight gain was seen in both groups, paritcularly during the ifrst 3 months of treatment:62%of the increase in BMI in both groups had occurred by the end of the 3rd month of treatment. No between-group differences in weight changes were observed. The correlaiton between changes in weight and changes in prolacitn levels were weakly posiitve:rs=0.17 (p=0.104) in the risperidone group and r=0.07 (p=0.862) in the queitapine group. Conclusions:Risperidone and queitapine had similar effcacy in the ifrst year of treatment of ifrst-episode schizophrenia though risperidone was more rapidly effecitve. Use of risperidone was associated with chronic hyperprolacitnemia but this did not occur with queitapine. Long-term use of both drugs was associated with sustained weight gain;the itming and magnitude of the weight gain is similar for the two drugs. Weight gain was not strongly related to changes in prolacitn levels.