抗精神病药物所致高泌乳素血症的用药研究

摘要/Abstract

摘要： 目的：探讨抗精神病药物所致高泌乳素血症的用药特征与规律，为临床用药提供参考。方法：选取2018年12月至2019年2月期间某院248例抗精神病药物所致高泌乳素血症患者的临床信息，采用频数分析法和关联分析法探讨使用抗精神病药所致高泌乳素血症的情况。结果：248例抗精神病药物所致高泌乳素血症患者中女性188例(75.81%)；年龄在31～45岁的女性患者有66例(35.11%)，比例最高。高泌乳素血症患者中女性泌乳素水平(123.04±51.89) ng·mL-1明显高于男性(69.98±16.74) ng·mL-1；年龄31～45岁患者泌乳素水平(129.47±62.29) ng·mL-1高于其他年龄组。频数分析结果显示，药物使用频率排在前3位的分别是氨磺必利103例(36.27%)、利培酮84例(29.58%)和奥氮平69例(24.30%)。关联分析结果显示，联合用药使用频率排在前3位的分别是氨磺必利与氯氮平32例(12.26%)、利培酮与氯氮平21例(8.05%)和氨磺必利与奥氮平18例(6.90%)。高泌乳素血症患者中有202例(81.45%)未给予相应治疗措施，其中133例转归情况不明。结论：年龄在31～45岁之间的女性患者服用氨磺必利、利培酮或奥氮平治疗出现高泌乳素血症最常见，临床用药应给予重点关注。

关键词: 抗精神病药物, 高泌乳素血症, 氨磺必利, 利培酮, 奥氮平

Abstract: Objective： To explore the condition of medicine use among patients with hyperprolactinemia caused by antipsychotics， and to provide reference for clinical medication. Methods：248 cases of data were collected from hospital information system (HIS) database in a Psychiatric Hospital and statistical analysis was done. Results： Through 248 cases studied， 188 (75.81%) were females， which 35% of the cases were between 16-30 years. Serum prolactin levels were significantly higher in women than men (123.04±51.89 ng·mL-1 vs 69.98±16.74 ng·mL-1，P<0.001). There were statistically significant differences in prolactin level of patients among five age groups（P<0.05）and the median prolactin level in patients aged 31~45 years (129.47±62.29) ng·mL-1 was significant higher than other groups. Top three most frequently used drugs were Amisulpride (36.27%， 103/248)， Risperidone (29.58%， 84/248) and Olanzapine (24.30%， 69/248). Top three most frequent drug combinations were Amisulpride+Clozapine (12.26%， 32/261)， Risperidone+Clozapine (8.05%， 21/261)， Amisulpride+Olanzapine (6.90%， 18/261). 202 cases (81.45%， 202/248) continued antipsychotic and received no treatment for hyperprolactinemia， of which prognosis of 152 cases (61.29%， 152/248) were unknown. Conclusion：Women aged 31~45 years during antipsychotics (Amisulpride， Risperidone or Olanzapine ) treatment are at high risk of hyperprolactinaemia，to which special attention should be paid in clinical practice.

Key words: Antipsychotics, Hyperprolatinemia, Amisulpride, Risperidone, Olanzapine

陈晓慧, 刘小俊. 抗精神病药物所致高泌乳素血症的用药研究[J]. 中国药物评价, 2019, 36(5): 376-379.

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