利培酮引起的高泌乳素相关因素分析

目的探讨利培酮所致高泌乳素(PRL)的危险因素,以指导临床合理用药。方法选取使用利培酮治疗6周的精神分裂症患者90例,收集其临床一般资料,包括性别、年龄、体质量指数(BMI)及阳性和阴性症状量表(PANSS)评分,检测所有患者的利培酮血药浓度、空腹血糖、总胆固醇(TC)、三酰甘油(TG)和PRL水平。依据血浆PRL水平将患者分为高PRL(PRL≥30 ng/mL)组和正常PRL(PRL<30 ng/mL)组。结果高PRL组女性比例高于正常PRL组(P<0.001),PANSS评分和空腹血糖低于正常PRL组(P<0.001),2个组之间年龄、BMI、TC、TG、利培酮血药浓度差异均无统计学意义(P>0.05)。Logistic回归分析结果显示,性别(女性)、PANSS评分降低和空腹血糖降低是高PRL的危险因素比值比(OR)值分别为15.843、0.466、0.053,95%可信区间(CI)分别为5.329~47.105、0.259~0.838、0.014~0.202,P<0.05]。年龄、BMI、TC、TG和利培酮血药浓度均不是高PRL的危险因素(OR值分别为1.016、1.623、0.449、0.650、0.399,P>0.05)。高PRL女性患者的PRL水平显著高于男性(P<0.001)。结论女性患者服用利培酮易发生高PRL,服用利培酮患者PANSS评分和空腹血糖过低易发生高PRL。建议临床个性化给药。

High prolactin caused by risperidone related factors

Objective To study high prolactin(PRL)caused by risperidone-related factors,and to guide clinicians using drugs rationally.Methods Totally,90 patients with schizophrenia were enrolled after treatment of risperidone for 6 weeks.The general data,including age,sex,body mass index(BMI),positive and negative syndrome scale(PANSS)score,plasma concentration of risperidone,fasting blood glucose,total cholesterol(TC),triglyceride(TG)and the level of PRL,were collected.According to plasma concentrations of PRL,the research subjects were classified into high PRL group(PRL≥30 ng/mL)and normal PRL group(PRL<30 ng/mL).Results The proportion of females in high PRL group was higher than that in normal PRL group(P<0.001),and PANSS score and fasting blood glucose were lower than those in normal PRL group(P<0.001).Age,BMI,TC,TG and plasma concentration of risperidone had no statistical significance between the 2 groups(P>0.05).Logistic regression analysis showed that high PRL was associated with sex(female),PANSS score and fasting blood glucoseodds ratios(OR)were 15.843,0.466 and 0.053,95%confidence intervals(CI)were 5.329-47.105,0.259-0.838 and 0.014-0.202,P<0.05].Age,BMI,TC,TG and plasma concentration of risperidone were not risk factors for high PRL(OR=1.016,1.623,0.449,0.650 and 0.399,P>0.05).PRL in female patients was higher than that in male patients(P<0.001).Conclusions Female patients taking risperidone are easier to be high PRL,and patients taking risperidone with low PANSS score and low fasting blood glucose are tended to be high PRL.Clinicians should use individualized medication.