长期使用升高催乳素的抗精神病药物对精神分裂症患者骨密度的影响。
Effects of long-term prolactin-raising antipsychotic medication on bone mineral density in patients with schizophrenia.
作者信息
Meaney A M, Smith S, Howes O D, O'Brien M, Murray R M, O'Keane V
机构信息
Beaumont Hospital, Dublin, Ireland.
出版信息
Br J Psychiatry. 2004 Jun;184:503-8. doi: 10.1192/bjp.184.6.503.
BACKGROUND
High rates of osteoporosis in schizophrenia may result from the prolactin-raising effects of some antipsychotic medication. Aims To examine bone mineral density in relation to relevant endocrine variables in patients with schizophrenia taking prolactin-raising antipsychotics.
METHOD
Fifty-five patients who had been receiving prolactin-raising antipsychotic medication for >10 years underwent dual-energy X-ray absorptiometry of their lumbar and hip bones. Among the endocrine variables assessed were plasma prolactin and sex hormones.
RESULTS
Age-related reduced bone mineral density measures were found in 17 (57%) of the male and 8 (32%) of the female patients. Higher doses of the female patients. Higher doses of medication were associated with increased rates of both hyperprolactinaemia and bone mineral density loss. Bone loss for the whole group was correlated with medication dose, and for men was inversely correlated with testosterone values.
CONCLUSIONS
These results suggest that patients with schizophrenia on long-term prolactin-raising antipsychotic medication are at high risk of developing reduced bone mineral density as a consequence of hyperprolactinaemia-induced hypogonadism.
背景
精神分裂症患者中骨质疏松症的高发病率可能源于某些抗精神病药物引起的催乳素升高作用。目的：研究服用可升高催乳素的抗精神病药物的精神分裂症患者的骨密度与相关内分泌变量之间的关系。
方法
55名服用可升高催乳素的抗精神病药物超过10年的患者接受了腰椎和髋部的双能X线吸收测定。评估的内分泌变量包括血浆催乳素和性激素。
结果
17名（57%）男性患者和8名（32%）女性患者出现了与年龄相关的骨密度降低。女性患者用药剂量更高。更高的药物剂量与高催乳素血症和骨密度丧失的发生率增加相关。整个组的骨质流失与药物剂量相关，而男性的骨质流失与睾酮值呈负相关。
结论
这些结果表明，长期服用可升高催乳素的抗精神病药物的精神分裂症患者因高催乳素血症引起的性腺功能减退而有发生骨密度降低的高风险。
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