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使用抗精神病药物治疗的患者肝功能检查结果的改变。

Alterations of liver function test in patients treated with antipsychotics.

作者信息

Garcia-Unzueta M Teresa, Herran Andres, Sierra-Biddle Deirdre, Amado J Antonio, Vázquez-Barquero J Luis, Alvarez Concepción

机构信息

Department of Endocrinology, University Hospital "Marqués de Valdecilla," University of Cantabria, Santander, Spain.

出版信息

J Clin Lab Anal. 2003;17(6):216-8. doi: 10.1002/jcla.10094.

Abstract

The prevalence of alterations of liver function tests in patients treated with a wide range of antypsychotics is unknown. The aim of this study was to analyze the effects of antipsychotics on liver function tests in a population of schizophrenic outpatients. Concentrations of AST, ALT, GGT, alkaline phosphatase, albumin, and bilirubin were determined in 54 patients fitting DSM-IV criteria of schizophrenia, and the same number of sex- and age-matched healthy subjects. Assessments included the Clinical Global Impression (CGI) and the Positive and Negative Syndrome Scale (PANSS) in addition to treatment related variables. Transaminases concentrations were slightly elevated in study patients compared to healthy controls, but without statistical significance. Alkaline phosphatase showed higher values in schizophrenic patients. Albumin and bilirubin were lower in study patients. Liver function tests abnormalities were found in about 10% of schizophrenic patients treated with antipsychotics. Treatment with depot phenotiazines induces alteration in these tests more frequently than treatment with other antipsychotics. PANSS negative subscale scores directly correlated with alkaline phosphatase and inversely correlated with albumin. A substantial number of patients in treatment with antipsychotic drugs present alterations of liver function tests. Both pharmacological and clinical factors could be related with these alterations.

摘要

使用多种抗精神病药物治疗的患者肝功能检查结果改变的发生率尚不清楚。本研究的目的是分析抗精神病药物对一组精神分裂症门诊患者肝功能检查的影响。对符合DSM-IV精神分裂症标准的54例患者以及相同数量的性别和年龄匹配的健康受试者测定了AST、ALT、GGT、碱性磷酸酶、白蛋白和胆红素的浓度。评估包括临床总体印象量表(CGI)和阳性与阴性症状量表(PANSS)以及与治疗相关的变量。与健康对照组相比,研究患者的转氨酶浓度略有升高,但无统计学意义。精神分裂症患者的碱性磷酸酶值较高。研究患者的白蛋白和胆红素较低。在使用抗精神病药物治疗的精神分裂症患者中,约10%发现肝功能检查异常。长效吩噻嗪类药物治疗比其他抗精神病药物治疗更频繁地导致这些检查结果改变。PANSS阴性分量表评分与碱性磷酸酶直接相关,与白蛋白呈负相关。大量接受抗精神病药物治疗的患者存在肝功能检查结果改变。药理学和临床因素都可能与这些改变有关。

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