阿立哌唑对男性精神分裂症患者继发药源性性功能障碍的影响

发布时间：2018-06-28 21:15

本文选题：精神分裂症 + 性功能障碍　；参考：《中华男科学杂志》2017年07期

【摘要】：目的:探讨阿立哌唑治疗氨磺必利或利培酮致男性精神分裂症患者性功能障碍的临床疗效。方法:2014年10月至2016年10月收治的75例经氨磺必利或利培酮治疗后继发性功能障碍的首发精神分裂症患者为研究对象,采用交叉换药法2周内停服氨磺必利或利培酮,并逐渐增加阿立哌唑口服剂量至20~30 mg/d,第3周开始30 mg/d维持,记录阿立哌唑换药前、治疗4、8周后患者者性功能、催乳素(PRL)、睾酮(T)、阳性和阴性症状量表评分(PANSS)变化及药物不良反应。结果:75例患者改服阿立哌唑4周,患者性功能总评分[(32.6±3.6)分vs(24.3±2.1)分]、T[(17.4±3.0))mmol/L vs(13.3±2.7)mmol/L]均较换药前明显上升(P均0.05),PRL[(27.9±8.2)ng/ml vs(38.5±10.5)ng/ml]显著下降(P0.05);治疗8周,患者性欲评分、T、PRL均已恢复至入院时基线水平,性功能评分中勃起评分、射精评分、性满意度评分、总评分及T数值已超过基线水平,但差异均无统计学意义(P0.05)。改服阿立哌唑4周后,患者PANSS评分均较换药前显著下降[(57.2±5.5)分vs(62.1±4.9)分,P0.05];治疗8周后PANSS评分显著低于治疗4周后评分[(51.2±5.2)分vs(57.2±5.5)分,P0.05]。改服阿立哌唑后,兴奋、头晕、失眠、食欲减退的发生率分别为6.7%、5.3%、4.0%、1.3%,未见其他严重不良发应。结论:阿立哌唑治疗男性精神分裂症合并药源性性功能障碍,能在继续改善阳性与阴性症状的同时,改善患者性功能,恢复生殖激素水平。
[Abstract]:Objective: to investigate the clinical efficacy of aripiprazole in the treatment of sexual dysfunction in male schizophrenic patients induced by amitropiride or risperidone. Methods: from October 2014 to October 2016, 75 patients with first-episode schizophrenia with secondary dysfunction after treatment with ambropiride or risperidone were studied. The oral dose of aripiprazole was gradually increased to 20 ~ 30 mg / d and maintained at 30 mg/d from the 3rd week. The changes of sexual function, prolactin (PRL), testosterone (T), positive and negative symptom scale (PANSS) and adverse drug reactions were recorded before and after 4 weeks of treatment with aripiprazole. Results the total score of sexual function of 75 patients [(32.6 卤3.6) vs (24.3 卤2.1)] T [(17.4 卤3.0) mmol / L vs (13.3 卤2.7) mmol / L] was significantly higher than that before treatment (P 0.05), and the total score of sexual function [(27.9 卤8.2) ng/ml vs (38.5 卤10.5) ng/ml] decreased significantly (P0.05). Erectile score ejaculation score sexual satisfaction score total score and T value exceeded the baseline level but the difference was not statistically significant (P0.05). After 4 weeks of treatment with aripiprazole, the PANSS scores of the patients were significantly lower than those of the patients before dressing change [(57.2 卤5.5) vs (62.1 卤4.9), P0.05], and the PANSS scores after 8 weeks were significantly lower than those after 4 weeks of treatment [(51.2 卤5.2) vs (57.2 卤5.5), P0.05]. After taking aripiprazole instead, the incidence of excitement, dizziness, insomnia and loss of appetite were 6.7and 5.34.0mg / 1.3respectively. Conclusion: aripiprazole in the treatment of male schizophrenia with drug-induced sexual dysfunction can continue to improve the positive and negative symptoms at the same time improve the sexual function of patients and restore the level of reproductive hormones.
【作者单位】：佛山市第三人民医院精神科;
【分类号】：R698;R749.3

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