氯氮平对精神分裂症患者骨密度、睾酮、泌乳素及骨质疏松的影响

Effect of clozapine on bone mineral density and prolactin secretion in patients with schizophrenia

摘要:

目的 探讨氯氮平对精神分裂症患者骨密度、睾酮、泌乳素及骨质疏松的影响。方法 选取2018年 5月—2019年5月武汉市精神卫生中心确诊为精神分裂症的患者150例作为研究对象，根据数字表法将纳入者分为实验组和对照组，每组75例。对照组给予利培酮治疗，实验组给予氯氮平治疗。观察比较两组患者服用药物3个月、6个月及9个月时骨密度、睾酮、泌乳素、骨钙素、血磷及血钙的变化。结果 不同时间点的骨密度、睾酮及泌乳素有差异（P?<0.05）；两组骨密度和睾酮无差异（P?>0.05），但泌乳素有差异（P?<0.05）；两组骨密度、睾酮和泌乳素变化趋势无差异（P?>0.05）。不同时间点的骨钙素、血磷及血钙有差异（P?<0.05）；两组骨钙素和血钙无差异（P?>0.05），但血磷有差异（P?<0.05）；两组骨钙素、血磷及血钙变化趋势无差异（P?>0.05）。实验组治疗3个月、6个月及9个月时骨质疏松发生率分别为12.00%、29.33%和41.33%，低于对照组20.00%、45.33%和54.66%（P?<0.05）。结论 精神分裂症患者应用氯氮平治疗对患者骨密度、睾酮、泌乳素分泌量、骨质疏松症状的影响程度较利培酮小，值得临床推广使用。

Abstract:

Objective To study the effects of clozapine on bone mineral density, prolactin secretion and osteoporosis in patients with schizophrenia. Methods From May 2018 to May 2019, 150 patients with schizophrenia diagnosed by Wuhan Mental Health Center were selected. According to the digital table method, the subjects were divided into experimental group and control group, 75 cases in each group. Risperidone was given for treatment of control group, and the experimental group was given clozapine treatment. The effects of bone mineral density, prolactin, BGP, serum calcium and blood phosphorus were observed at 3, 6 and 9 months after treatment. Results The differences of BMD, T, prolactin, BGP, blood phosphorus and blood calcium between the experimental group and the control group were statistically significant (P??0.05), but there was significant difference between the two groups (P??0.05). There was no difference between the experimental group and the control group in BGP and blood calcium levels (P?>?0.05), but there was a significant difference in blood phosphorus level (P??0.05). The incidence of osteoporosis in the experimental group was 12.00%, 29.33% and 41.33% at 3, 6 and 9 months, respectively, lower than that in the control group (20.00%, 45.33% and 54.66%) (P?