摘要
目的 分析阿立哌唑对男性首发精神分裂症(SCH)患者性激素、心肌酶谱及勃起功能的影响.方法 回顾性收集2023年1月至2024年1月秦皇岛市九龙山医院收治的120例男性首发SCH患者的临床资料.根据治疗方法不同分为利培酮组(n=60)、阿立哌唑组(n=60).利培酮组患者口服利培酮,初始给药量1 mg/d,1～2周给药剂量逐渐增加至6 mg/d,1次/d.阿立呱唑组患者口服阿立呱唑,初始给药量5 mg/d,治疗2～3周剂量增加至30 mg/d,1次/d.比较两组疗效,对比两组治疗前和治疗2个月后空腹血糖、总胆固醇、甘油三酯、性激素(睾酮、雌二醇、黄体生成素)、心肌酶[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]变化、国际勃起功能指数-5问卷(IIEF-5)评分变化,比较两组药物不良反应发生情况.结果 治疗2个月后,两组睾酮、雌二醇、黄体生成素水平均较治疗前明显升高,阿立哌唑组的睾酮、雌二醇、黄体生成素水平分别为(4.89±0.47)ng/mL、(36.27±3.74)ng/mL、(6.21±0.68)mU/mL,均明显高于利培酮组[(4.05±0.41)ng/mL、(32.22±3.36)ng/mL、(5.11±0.52)mU/mL],差异均有统计学意义(P＜0.05).治疗2个月后,两组CK、CK-MB、LDH水平均较治疗前明显降低,阿立哌唑组CK、CK-MB、LDH 水平分别为(111.34±11.23)、(19.24±1.95)、(147.66±15.24)U/L,均明显高于利培酮组[(101.22±10.56)、(16.32±1.85)、(121.85±13.26)U/L],差异均有统计学意义(P＜0.05).治疗2个月后,利培酮组的性信心、性驱动、性高潮满意度、性唤起、阴茎勃起能力评分均较治疗前明显降低,阿立哌唑组性信心、性驱动、性高潮满意度、性唤起、阴茎勃起能力评分分别为(3.75±0.38)、(3.93±0.39)、(3.85±0.38)、(4.08±0.41)、(3.97±0.40)分,均明显高于利培酮组[(2.29±0.22)、(2.41±0.25)、(2.07±0.19)、(2.71±0.28)、(2.20±0.22)分],差异均有统计学意义(P＜0.05).结论 阿立哌唑对男性首发SCH患者疗效明确,有效调节患者性激素水平,减轻心肌损伤、勃起功能障碍等.
Abstract
Objective To analyze the effect of aripiprazole on sex hormones,myocardial enzymes and erectile function in male patients with first-episode schizophrenia(SCH).Methods The clinical data of 120 male patients with first-episode SCH admitted to Qinhuangdao Jiu-longshan Hospital from January 2023 to January 2024 were collected retrospectively.According to different treatment methods,the patients were di-vided into the risperidone group(n=60)and the aripiprazole group(n=60).The risperidone group received oral administration of risperidone at an initial dose of 1 mg/d,and the dose was gradually increased to 6 mg/d after 1-2 weeks of treatment,1 time/d.The aripiprazole group re-ceived oral administration of aripiprazole at an initial dose of 5 mg/d,and the dose was increased to 30 mg/d after 2-3 weeks of treatment,1 time/d.The efficacy,the changes in fasting blood glucose,total cholesterol,triacylglycerol,sex hormones(testosterone,estradiol and luteinizing hormone),myocardial enzymes[creatine kinase(CK),creatine kinase isozyme(CK-MB)and lactate dehydrogenase(LDH)]and the Interna-tional Index of Erectile Function(IIEF-5)scores before treatment and after 2 months of treatment,and adverse drug reactions of two groups were compared.Results After 2 months of treatment,the levels of testosterone,estradiol and luteinizing hormone in the two groups were significantly higher than those before treatment.The levels of testosterone,estradiol and luteinizing hormone in the aripiprazole group were(4.89±0.47)ng/mL,(36.27±3.74)ng/mL and(6.21±0.68)mU/mL,respectively,which were significantly higher than those in the risperidone group[(4.05±0.41)ng/mL,(32.22±3.36)ng/mL,(5.11±0.52)mU/mL],the differences were statistically significant(P＜0.05).After 2 months of treatment,the levels of CK,CK-MB and LDH in the two groups were significantly lower than those before treatment,and the levels of CK,CK-MB and LDH in the aripiprazole group were(111.34±11.23),(19.24±1.95)and(147.66±15.24)U/L,respectively,which were significantly higher than those in the risperidone group[(101.22±10.56),(16.32±1.85),(121.85±13.26)U/L],the differences were statistically significant(P＜0.05).After 2 months of treatment,the scores of sexual confidence,sexual drive,orgasm satisfaction,sexual arousal and penile erection ability in risperidone group were significantly lower than those before treatment,and the scores of sexual confidence,sexual drive,orgasm satisfaction,sexual arousal and penile erection ability in aripiprazole group were(3.75±0.38),(3.93±0.39),(3.85±0.38),(4.08±0.41)and(3.97±0.40),respectively,which were significantly higher than those in risperidone group[(2.29±0.22),(2.41±0.25),(2.07±0.19),(2.71±0.28),(2.20±0.22)points],the differences were statistically significant(P＜0.05).Conclusion Aripiprazole is effective in the treatment of male patients with first-episode SCH.It can effectively regulate the levels of sex hormones,and reduce myocardial injury as well as erectile dysfunction.
维普
万方数据