氨磺必利致精神分裂症患者显著泌乳素升高的影响因素研究
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摘要
目的:探讨精神分裂症患者氨磺必利治疗后血清泌乳素(PRL)升高的影响因素。方法:给予48例精神分裂症患者氨磺必利治疗8周;在基线、治疗后4及8周时检测血清PRL水平及氨磺必利血药浓度。以治疗8周时血清PRL 1 600 m IU/L为界,将入组者分为显著PRL升高组和非显著PRL升高组,比较两组人口学及临床资料,分析氨磺必利治疗后血清PRL升高的影响因素。结果:治疗8周后24例归入显著PRL升高组,24例归入非显著PRL升高组。与非显著PRL升高组比较,显著PRL升高组的氨磺必利剂量更大、女性及基线时PRL水平高于正常的比例更高(P<0.05或P<0.01)。回归分析显示,女性的OR值为13.933(95%CI=2.636~73.648,P<0.05),基线PRL高于正常的OR值为5.728(95%CI:1.142~28.741,P<0.01)。结论:女性及基线时PRL水平高于正常是精神分裂症患者使用氨磺必利后显著PRL升高的危险因素。
Objective: To investigate the factors of amisulpride-induced marked prolactin elevation in schizophrenia. Method: A total of 48 patients with schizophrenia were enrolled and treated with amisupride for 8 weeks. Level of serum prolactin was measured at baseline,week 4,and 8. Plasma concentration of amisulpride was measured at week 4,and 8. Patients were divided into two groups: marked prolactin elevation group and not marked prolactin elevation group by level of serum prolactin 1 600 m IU/L at week 8. Two groups of demographic and clinical datas were compared to analyze the factors of amisulpride-induced marked prolactin elevation in schizophrenia. Results: 24 patients are grouped into marked prolactin elevation group and 24 patients are grouped into not marked prolactin elevation group. Compared with patients in not marked prolactin elevation group,the patients in marked prolactin elevation group were younger and prescribed higher doses of amisulpride and the ratio of women,prolactin elavation of baseline were significant higher( P < 0. 05 or P <0. 01). The results of Logistic regression analysis indicated that the odds ratio of women was 13. 933( 95% CI:2. 636-73. 648,P < 0. 01),and the odds ratio of the basic level of prolactin above normal was 5. 728( 95% CI:1. 142-28. 741,P < 0. 05). Conclusion: Women and the basic level of prolactin above normal are the risk factors of the marked prolactin elevation due to amisulpride in schizophrenia.
Objective: To investigate the factors of amisulpride-induced marked prolactin elevation in schizophrenia. Method: A total of 48 patients with schizophrenia were enrolled and treated with amisupride for 8 weeks. Level of serum prolactin was measured at baseline,week 4,and 8. Plasma concentration of amisulpride was measured at week 4,and 8. Patients were divided into two groups: marked prolactin elevation group and not marked prolactin elevation group by level of serum prolactin 1 600 m IU/L at week 8. Two groups of demographic and clinical datas were compared to analyze the factors of amisulpride-induced marked prolactin elevation in schizophrenia. Results: 24 patients are grouped into marked prolactin elevation group and 24 patients are grouped into not marked prolactin elevation group. Compared with patients in not marked prolactin elevation group,the patients in marked prolactin elevation group were younger and prescribed higher doses of amisulpride and the ratio of women,prolactin elavation of baseline were significant higher( P < 0. 05 or P <0. 01). The results of Logistic regression analysis indicated that the odds ratio of women was 13. 933( 95% CI:2. 636-73. 648,P < 0. 01),and the odds ratio of the basic level of prolactin above normal was 5. 728( 95% CI:1. 142-28. 741,P < 0. 05). Conclusion: Women and the basic level of prolactin above normal are the risk factors of the marked prolactin elevation due to amisulpride in schizophrenia.
引文
[1]程玉红,康江鹏,陈蔚,等.氨磺必利的合成[J].中国医药工业杂志,2011,42(11):801-803.
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[6]Moller HJ.Amisulpride:limbic specificity and the mechanism of antipsychotic atypicality[J].Progress Neuropsychopharmacology Biological Psychiatry,2003,27(7):1101-1111.
[7]Halbreich U,Kinon BJ,Gilmore JA,et al.Elevated prolactin levels in patients with schizophrenia:mechanisms and related adverse effects[J].Psychoneuroendocrinology,2003,28(Suppl 1):s53-67.
[8]Park EJ,Park YM.The short-term effects of risperidone-induced hyperprolactinemia on lipid metabolism in drug-naive children and adolescents[J].Psychiatry Investigation,2015,12(1):55-60.
[9]Suzuki Y,Ono S,Sugai T,et al.Dose-dependent effects of olanzapine on QT intervals and plasma prolactin levels in Japanese patients with stable schizophrenia[J].Human Psychopharmacology,2011,26(6):440-443.
[10]Dos Santos Junior A,Henriques TB,de Mello MP,et al.Hyperprolactinemia in children and adolescents with use of risperidone:clinical and molecular genetics aspects[J].J Child Adolescent Psychopharmacology,2015,25(10):738-748.
[11]Kim EY,Kim SH,Lee NY,et al.Relationship between prolactin levels and subjective endocrine-related adverse effects in patients with schizophrenia receiving long-term treatment with amisulpride[J].Pharmacopsychiatry,2012,45(2):57-63.
[12]Lee BH,Kang SG,Kim TW,et al.Hyperprolactinemia induced by low-dosage amisulpride in Korean psychiatric patients[J].Psychiatry Clinical Neurosciences,2012,66(1):69-73.
[13]Wang ZM,Xiang YT,An FR,et al.Frequency of hyperprolactinemia and its associations with demographic and clinical characteristics and antipsychotic medications in psychiatric inpatients in China[J].Perspectives Psychiatric Care,2014,50(4):257-263.
[14]Englisch S,Enning F,Grosshans M,et al.Quetiapine combined with amisulpride in schizophrenic patients with insufficient responses to quetiapine monotherapy[J].Clinical Neuropharmacology,2010,33(5):227-229.
[15]Toledo-Romero F,Molina JD,Lopez-Rodriguez E,et al.Augmentation with amisulpride for schizophrenic patients non-responsive to risperidone monotherapy[J].Pharmacopsychiatry,2014,48(2):51.
[2]Paparrigopoulos T,Liappas J,Tzavellas E,et al.Amisulpride-induced hyperprolactinemia is reversible following discontinuation[J].Progress Neuropsychopharmacology Biological Psychiatry,2007,31(1):92-96.
[3]Cookson J,Hodgson R,Wildgust HJ.Prolactin,hyperprolactinaemia and antipsychotic treatment:a review and lessons for treatment of early psychosis[J].J Psychopharmacology(Oxford,England),2012,26(Suppl 5):s42-51.
[4]Peuskens J,Pani L,Detraux J,et al.The effects of novel and newly approved antipsychotics on serum prolactin levels:a comprehensive review[J].CNS Drugs,2014,28(5):421-453.
[5]Serri O,Chik CL,Ur E,et al.Diagnosis and management of hyperprolactinemia[J].CMAJ,2003,169(6):575-581.
[6]Moller HJ.Amisulpride:limbic specificity and the mechanism of antipsychotic atypicality[J].Progress Neuropsychopharmacology Biological Psychiatry,2003,27(7):1101-1111.
[7]Halbreich U,Kinon BJ,Gilmore JA,et al.Elevated prolactin levels in patients with schizophrenia:mechanisms and related adverse effects[J].Psychoneuroendocrinology,2003,28(Suppl 1):s53-67.
[8]Park EJ,Park YM.The short-term effects of risperidone-induced hyperprolactinemia on lipid metabolism in drug-naive children and adolescents[J].Psychiatry Investigation,2015,12(1):55-60.
[9]Suzuki Y,Ono S,Sugai T,et al.Dose-dependent effects of olanzapine on QT intervals and plasma prolactin levels in Japanese patients with stable schizophrenia[J].Human Psychopharmacology,2011,26(6):440-443.
[10]Dos Santos Junior A,Henriques TB,de Mello MP,et al.Hyperprolactinemia in children and adolescents with use of risperidone:clinical and molecular genetics aspects[J].J Child Adolescent Psychopharmacology,2015,25(10):738-748.
[11]Kim EY,Kim SH,Lee NY,et al.Relationship between prolactin levels and subjective endocrine-related adverse effects in patients with schizophrenia receiving long-term treatment with amisulpride[J].Pharmacopsychiatry,2012,45(2):57-63.
[12]Lee BH,Kang SG,Kim TW,et al.Hyperprolactinemia induced by low-dosage amisulpride in Korean psychiatric patients[J].Psychiatry Clinical Neurosciences,2012,66(1):69-73.
[13]Wang ZM,Xiang YT,An FR,et al.Frequency of hyperprolactinemia and its associations with demographic and clinical characteristics and antipsychotic medications in psychiatric inpatients in China[J].Perspectives Psychiatric Care,2014,50(4):257-263.
[14]Englisch S,Enning F,Grosshans M,et al.Quetiapine combined with amisulpride in schizophrenic patients with insufficient responses to quetiapine monotherapy[J].Clinical Neuropharmacology,2010,33(5):227-229.
[15]Toledo-Romero F,Molina JD,Lopez-Rodriguez E,et al.Augmentation with amisulpride for schizophrenic patients non-responsive to risperidone monotherapy[J].Pharmacopsychiatry,2014,48(2):51.