摘要
目的 探讨典型、非典型抗精神病药对精神分裂症神经内分泌、免疫、自由基代谢的作用及其与疗效的关系。方法 用固定剂量（ 利培酮为６ ｍｇ／ｄ，氟哌啶醇２０ ｍｇ／ｄ，在１ 周内增至治疗量）利培酮、氟哌啶醇随机、双盲治疗７８ 例精神分裂症例患者１２ 周，在治疗前后分别评定阳性和阴性症状量表（ＰＡＮＳＳ），并测定帕罗西汀激发的神经内分泌试验、白细胞介素２（ＩＬ２） 、白细胞介素８（ＩＬ８）和超氧化物歧化酶（ＳＯＤ）等。同期选取无精神病和精神病家族史的健康人１８ 名为对照组。结果 （１） 治疗前患者组帕罗西汀激发的皮质醇应答、ＳＯＤ 值、血浆ＩＬ２、ＩＬ８ 均高于对照组（ Ｐ＜ ０－０５ ～０－０１） 。（２） 利培酮、氟哌啶醇治疗均使帕罗西汀激发的催乳素增加，两者间差异无显著性（Ｐ＞ ０－０５）；而利培酮对帕罗西汀激发皮质醇应答的阻滞作用强于氟哌啶醇的作用（ Ｐ＜０－０５） 。两种药物均降低ＳＯＤ值和ＩＬ２、ＩＬ８ 水平，差异无显著性。（３） 生物学指标变化与疗效之间存在一定关系，主要表现为ＰＡＮＳＳ减分率与治疗前后皮质醇曲线下面积差值、与治疗前后催乳素差值均显著正相关（ｒ＝ ０－４４，Ｐ＜０－０１；ｒ＝０－３３，Ｐ＜０－０?
Objective To explore the effect of typical or atypical antipsychotics on the neuroendocrine indices, immune parameters, free radical metabolism and the relationship with the outcome Methods Seventy eight inpatients with schizophrenia were treated with a fixed dose of risperidone or haloperidol for 12 weeks in a randomized, double blind design The Positive and Negative symptom Scale (PANSS) was rated before and after treatment The paroxetine evoked neuroendocrine response, plasma interleukin (IL) 2 and IL8, and the blood superoxide dismutase (SOD) levels were measured at pre and post treatment Results (1) At baseline, the cortisol response to paroxetine, blood SOD level, plasma IL 2 and IL 8 levels were significantly higher in patient group than in normal controls ( P< 0 05～0 01) (2) The prolactin level was both significantly increased in the risperidone or haloperidol treatment groups with no difference between these two groups ( P> 0 05) The inhibited effect of risperidone treatment on the paroxetine evoked cortisol response was markedly stronger than that of haloperidol ( P< 0 05) The blood SOD concentration, and IL 2, IL 8 levels were significantly decreased with the treatments of both two antipsychotics (3) There was a certain interrelation between the change of biological indices and the clinical effectiveness, showing the positive relation between the reduction rate of PANSS and the distance of the cortisol area under curve (AUC), or the distance of plasma prolactin level at pre and post treatment ( r = 0 44, P< 0 01; r = 0 33, P< 0 05) Conclusions The varied abnormalities of biological indices may present in schizophrenia The difference of risperidone and haloperidol treatment might lie in the neuroendocrine functions There may be certain relevance between the clinical effectiveness of antipsychotics and the change of biological parameters
出处
《中华精神科杂志》
CAS
CSCD
1999年第4期212-214,共3页
Chinese Journal of Psychiatry
关键词
精神分裂症
抗精神病剂
免疫测定
治疗
Schizophrenia Antipsychotic agents Neurosecretory systems Immunoassay Free radicals
