氨磺必利对首发女性精神分裂症患者甲状腺激素水平的影响
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摘要
目的探讨新一代抗精神病药物氨磺必利对首发女性精神分裂症患者甲状腺功能的影响,评估氨磺必利的临床疗效和安全性。方法筛选2015年1月-2016年5月在湖南省第二人民医院住院的、符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的首发女性精神分裂症患者40例为观察组,入院后给予氨磺必利治疗,1周内达到治疗剂量400~800 mg/d;同期选取40例健康体检者为对照组。于入组时和治疗4周末检测两组血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)水平,同期对观察组进行阳性和阴性症状量表(PANSS)评定。结果治疗前,观察组血清FT3、FT4、TSH水平低于健康对照组,差异均有统计学意义(P<0.05或0.01);与治疗前相比,观察组治疗后第4周末血清FT4和TSH水平较低(P<0.05或0.01);治疗4周末,观察组显著进步38例(95%)。结论首发女性精神分裂症患者在治疗前常常伴有甲状腺功能异常,氨磺必利可能有助于改善其精神症状,短期内采用氨磺必利治疗对首发女性精神分裂症患者甲状腺激素水平影响较大,治疗4周后FT4和TSH水平下降。
Objective To explore the effect of amisulpride on the thyroid function of female patients with first-episode schizophrenia and evaluate the clinical efficacy and safety of amisulpride. Methods From January 2015 to May 2016,40 patients with first-episode schizophrenia who were hospitalized in The Second People 's Hospital of Hu 'nan Province were selected as the observation group. These participants all met the diagnostic criteria for schizophrenia of International Classification of Diseases,tenth edition( ICD-10). After admission,they were treated with amisulpride,and within a week,the treatment increased to 400 ~ 800 mg/d. 40 healthy women were recruited as the control group during the same period. Before and after treatment for 4 weeks,the serum FT3,FT4 and TSH levels were tested,meanwhile the observation group was evaluated by Positive and Negative Symptom Scale( PANSS).Results Before treatment,the serum FT3,FT4 and TSH levels of the observation group were lower than those of the control group( P < 0. 05 or 0. 01). Compared with before treatment,the serum FT4 and TSH levels of the observation group were lower after treatment for 4 weeks( P < 0. 05 or 0. 01). After treatment for 4 weeks,the observation group improved significantly in 38 cases( 95%).Conclusion Female patients with first-episode schizophrenia often accompanied by abnormal thyroid function amisulpride may help to improve their psychiatric symptoms but decreased the FT4 and TSH level may cause big influence on patients' thyroid hormone level.
Objective To explore the effect of amisulpride on the thyroid function of female patients with first-episode schizophrenia and evaluate the clinical efficacy and safety of amisulpride. Methods From January 2015 to May 2016,40 patients with first-episode schizophrenia who were hospitalized in The Second People 's Hospital of Hu 'nan Province were selected as the observation group. These participants all met the diagnostic criteria for schizophrenia of International Classification of Diseases,tenth edition( ICD-10). After admission,they were treated with amisulpride,and within a week,the treatment increased to 400 ~ 800 mg/d. 40 healthy women were recruited as the control group during the same period. Before and after treatment for 4 weeks,the serum FT3,FT4 and TSH levels were tested,meanwhile the observation group was evaluated by Positive and Negative Symptom Scale( PANSS).Results Before treatment,the serum FT3,FT4 and TSH levels of the observation group were lower than those of the control group( P < 0. 05 or 0. 01). Compared with before treatment,the serum FT4 and TSH levels of the observation group were lower after treatment for 4 weeks( P < 0. 05 or 0. 01). After treatment for 4 weeks,the observation group improved significantly in 38 cases( 95%).Conclusion Female patients with first-episode schizophrenia often accompanied by abnormal thyroid function amisulpride may help to improve their psychiatric symptoms but decreased the FT4 and TSH level may cause big influence on patients' thyroid hormone level.
引文
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[7]Paunovic'VR,Timotijevic'I,Marinkovic'D.Neuroleptic actionson the thyroidaxis:different effecents of clozapine and haloperido[J].Int Clin Psychopharmacol,1991,6(3):133-139.
[8]李猛,朱俊敬,李文峰,等.伴攻击行为女性精神分裂症治疗前后甲状腺激素水平变化[J].精神医学杂志,2016,29(2):134-136.
[9]陈志强,周峰,陈惠萍.氨磺必利与利培酮治疗精神分裂症疗效和安全性的Meta分析[J].中国药师,2015,18(2):280-283.
[10]Kerwin R.From pharmacological profiles to clinical out comes[J].Int Clin Psychopharmacol,2000,15(4):1-4.
[11]Herrera-Estrella M,Apiquian R,Fresan A,et al.The effects of amisulpride on five dimensions of psychopathology in patients with schizophrenia:a prospective open-label study[J].BMC Psychiatry,2005,5(1):22.
[2]Palha JA,Goodman AB.Thyroid hormones and retinoids:a possible link between genes and environment in schizophrenia[J].Bain Res Rev,2006,51(1):61-71.
[3]Lobos CA,Komossa K,Rummel-Kluge C,et al.Clozapine versus other atypical antipsychotics for schizophrenia[M].The Cochrane Library.John Wiley&Sons,Ltd,2007:CD006633.
[4]Baumgartner A,Pietzcker A,Gaebel W.The hypothalamic-pituitary-thyroid axis in patients with schizophrenia[J].Schizophr Res,2000,44(3):233-243.
[5]寇泽刚.阿立哌唑、喹硫平和利培酮对精神分裂症患者甲状腺素水平的影响[J].蚌埠医学院学报,2015,40(9):1184-1186.
[6]王雁芬,陈晓慧,孙平平,等.阿立哌唑、喹硫平和利培酮对精神分裂症患者甲状腺素水平的影响[J].精神医学杂志,2014,27(1):45-47.
[7]Paunovic'VR,Timotijevic'I,Marinkovic'D.Neuroleptic actionson the thyroidaxis:different effecents of clozapine and haloperido[J].Int Clin Psychopharmacol,1991,6(3):133-139.
[8]李猛,朱俊敬,李文峰,等.伴攻击行为女性精神分裂症治疗前后甲状腺激素水平变化[J].精神医学杂志,2016,29(2):134-136.
[9]陈志强,周峰,陈惠萍.氨磺必利与利培酮治疗精神分裂症疗效和安全性的Meta分析[J].中国药师,2015,18(2):280-283.
[10]Kerwin R.From pharmacological profiles to clinical out comes[J].Int Clin Psychopharmacol,2000,15(4):1-4.
[11]Herrera-Estrella M,Apiquian R,Fresan A,et al.The effects of amisulpride on five dimensions of psychopathology in patients with schizophrenia:a prospective open-label study[J].BMC Psychiatry,2005,5(1):22.