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[与抗精神病药物治疗相关的高催乳素血症:临床特征及其对性功能的影响]

[Hyperprolactinemia associated with neuroleptic treatment: clinical characteristics and an impact on sexual function].

作者信息

Yunilaynen O A, Starostina E G, Dzeranova L K, Kudryashkina G N, Kesselman L G, Baranov P A, Dedov I I

机构信息

Mental Health Research Center, Moscow, Russia.

Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia; Moscow Institute of Psychiatry - Branch of Serbsky Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2016;116(11):17-25. doi: 10.17116/jnevro201611611117-25.

Abstract

AIM

To study clinical characteristics of antipsychotic-induced hyperprolactinemia (AIH) and an impact of AIH on sexual function in patients with mental disorders treated with neuroleptics for a long time.

MATERIAL AND METHODS

A cross-sectional study of 244 consecutive psychiatric in-patients (F/M=140/104) with mental disorders currently taking antipsychotics was carried out. The patients were screened for serum prolactin, sex hormones and gonadotropin levels. The UKU Side effects rating scale (UKU) was used to assess side-effects. For assessment of sexual dysfunction, the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ) was administered.

RESULTS AND CONCLUSION

Asymptomatic AIH was found in 16% of females and in 37% of males. AIH caused menstrual disorders (oligomenorrhea and amenorrhea), galactorrhea in females. AIH was associated with libido decrease and life quality impairment due to sexual dysfunctions in patients of both genders. AIH was associated with orgasm delay and vaginal dryness during sexual intercourse in females. In men, AIH was associated with erectile dysfunction. In contrast to pituitary tumor and idiopathic hyperprolactinemia, there was no association between AIH and weight gain and/or obesity, and hypogonadism in patients of both genders.

摘要

目的

研究抗精神病药物所致高催乳素血症(AIH)的临床特征以及AIH对长期使用抗精神病药物治疗的精神障碍患者性功能的影响。

材料与方法

对244例目前正在服用抗精神病药物的精神障碍住院患者(女性/男性=140/104)进行横断面研究。对患者进行血清催乳素、性激素和促性腺激素水平筛查。使用乌普萨拉监测中心副作用评定量表(UKU)评估副作用。采用精神药物相关性性功能障碍问卷(PRSexDQ)评估性功能障碍。

结果与结论

16%的女性和37%的男性存在无症状性AIH。AIH导致女性月经紊乱(月经过少和闭经)、溢乳。AIH与两性患者因性功能障碍导致的性欲减退和生活质量受损有关。AIH与女性性交时性高潮延迟和阴道干燥有关。在男性中,AIH与勃起功能障碍有关。与垂体瘤和特发性高催乳素血症不同,AIH与两性患者的体重增加和/或肥胖以及性腺功能减退无关。

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