CAJ | 학술논문

目的：探讨非典型抗精神病药利培酮、奥氮平对精神分裂症患者甲状腺功能的影响。方法将符合《中国精神障碍分类与诊断标准（第3版）》（CCMD-3）的54例精神分裂症患者，采用随机数字表法分成服用利培酮和奥氮平两组，其中利培酮组29例，给药初始剂量为4 mg/d，2周内逐渐加至6 mg/d，观察至8周末；奥氮平组25例，给药初始剂量为10 mg/d，2周内逐渐加至15mg/d，观察至8周末。分别在治疗前、治疗第8周末测血清总三碘甲状腺原氨酸（ TT3）、血清总甲状腺素（ TT4）、游离三碘甲状腺原氨酸（ FT3）、血清游离甲状腺素（ FT4）及促甲状腺激素（TSH）水平。结果利培酮组治疗前后血清TT3、TT4、FT3、FT4、TSH水平差异均无统计学意义（P﹥0.05），奥氮平组治疗前后血清TT3、TT4、TSH水平差异无统计学意义（ P﹥0.05），治疗前后FT3、FT4差异有统计学意义[（3.01±0.28）pg/mlvs.（2.81±0.26）pg/ml，（0.91±0.2）pg/mlvs.（0.77±0.14）pg/ml，P﹤0.05]。利培酮组治疗后血清TT3、FT3水平升高，较奥氮平组差异有统计学意义（ P﹤0.05）。结论利培酮对精神分裂症患者甲状腺功能无实质影响，奥氮平能影响精神分裂症患者血清FT3、FT4的水平，在治疗中应注意监测服用奥氮平的精神分裂症患者的甲状腺激素水平。
목적：탐토비전형항정신병약리배동、오담평대정신분렬증환자갑상선공능적영향。방법장부합《중국정신장애분류여진단표준（제3판）》（CCMD-3）적54례정신분렬증환자，채용수궤수자표법분성복용리배동화오담평량조，기중리배동조29례，급약초시제량위4 mg/d，2주내축점가지6 mg/d，관찰지8주말；오담평조25례，급약초시제량위10 mg/d，2주내축점가지15mg/d，관찰지8주말。분별재치료전、치료제8주말측혈청총삼전갑상선원안산（ TT3）、혈청총갑상선소（ TT4）、유리삼전갑상선원안산（ FT3）、혈청유리갑상선소（ FT4）급촉갑상선격소（TSH）수평。결과리배동조치료전후혈청TT3、TT4、FT3、FT4、TSH수평차이균무통계학의의（P﹥0.05），오담평조치료전후혈청TT3、TT4、TSH수평차이무통계학의의（ P﹥0.05），치료전후FT3、FT4차이유통계학의의[（3.01±0.28）pg/mlvs.（2.81±0.26）pg/ml，（0.91±0.2）pg/mlvs.（0.77±0.14）pg/ml，P﹤0.05]。리배동조치료후혈청TT3、FT3수평승고，교오담평조차이유통계학의의（ P﹤0.05）。결론리배동대정신분렬증환자갑상선공능무실질영향，오담평능영향정신분렬증환자혈청FT3、FT4적수평，재치료중응주의감측복용오담평적정신분렬증환자적갑상선격소수평。
Objective To explore the effect of olanzapine and risperidone on thyroid functions of schizophrenic patients. Methods 54 patients with schizophrenia who conform to CCMD-3 were randomly divided into two groups according to the random number table. The risperidone group 29 cases,the initial dose of 4 mg/d,2 weeks gradually increased to 6 mg/d,the observation to 8 weekends;olanzapine group 25 cases,the initial dose of 10 mg/d,2 week and gradually increased to 15mg/d,the observation to eight weekends. The patients in the two groups had no differences in age,sex,culture degree(P﹥0. 05). Respectively,test three measuring serum triiodothyronine( TT3 ),thyroxine( TT4 ),free three triiodothyronine( FT3 ),free thyroxine( FT4 )and thyroid stim-ulating hormone( TSH)level before treatment and eighth weekend. Results With the treatment of risperidone,TT3 ,TT4 ,FT3 ,FT4 , thyroid stimulating hormone( TSH)levels were increased,but the difference was not statistically significant,compared with the normal group,the increase of TT3 had statistical significance;the levels of TT3 ,TT4 ,FT3 ,FT4 were decreased after treatment with olanzap-ine,FT3 and FT4 decreased significantly before and after treatment[(3. 01 ± 0. 28)vs.(2. 81 ± 0. 26),(0. 91 ± 0. 2)vs.(0. 77 ± 0. 14),P﹤0. 05]. TSH increased,but without statistical significance. TT3 ,FT3 levels increased significantly after treatment with ris-peridone group,there is statistical significance compared with olanzapine group(P﹤0. 05). Conclusion Risperidone has no signifi-cant effect on patientˊs thyroid hormones. Olanzapine can affect patients with schizophrenia FT3 ,FT4 level,should pay attention to the monitoring using olanzapine in the treatment of thyroid function in patients with schizophrenia.