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催乳素和促甲状腺激素(TSH)水平与常规抗精神病药物治疗的精神分裂症患者的性功能障碍:一项横断面研究。

Prolactin and Thyroid Stimulating Hormone (TSH) Levels and Sexual Dysfunction in Patients with Schizophrenia Treated with Conventional Antipsychotic Medication: A Cross-Sectional Study.

机构信息

Sixth Affiliated Hospital, Kunming Medical University, Yuxi, Yunnan, China (mainland).

Xiangya Third Hospital, Central South University, Changsha, Hunan, China (mainland).

出版信息

Med Sci Monit. 2018 Dec 16;24:9136-9143. doi: 10.12659/MSM.913759.

Abstract

BACKGROUND This study aimed to investigate the relationship between serum profiles of prolactin and thyroid stimulating hormone (TSH) and sexual dysfunction in patients with schizophrenia treated with conventional antipsychotic medication. MATERIAL AND METHODS A hospital-based cross-sectional study included 118 patients, age range 18-57 years (55 men, 63 women), with a confirmed diagnosis of schizophrenia. All patients were stable after antipsychotic treatment. Serum levels of hormones, including prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone, testosterone, thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3) and free thyroxine (FT4), were detected in venous blood. The Positive and Negative Syndrome Scale (PANSS) score was used to measure symptom severity of patients with schizophrenia. The Mandarin Chinese version of the Arizona Sexual Experience Scale (ASEX), a 5-item scale, was used to measure sexual function. RESULTS There were 66 patients (55.9%) who had hyperprolactinemia, the prevalence of hyperprolactinemia was markedly higher in the sexual dysfunction group than the non-sexual dysfunction group (91.8% vs. 17.5%) (P<0.001). Mean prolactin levels were significantly increased in patients with sexual dysfunction compared with the patients without sexual dysfunction (P<0.001), with a higher incidence in female patients. Subclinical hypothyroidism and hyperprolactinemia were found to be independently associated with sexual dysfunction, and an increased PANSS negative score was an independent risk factor for the development of sexual dysfunction. CONCLUSIONS The incidence of sexual dysfunction was significantly increased in patients with schizophrenia. Hyperprolactinemia and subclinical hypothyroidism were associated with sexual dysfunction, especially in female patients.

摘要

背景

本研究旨在探讨常规抗精神病药物治疗的精神分裂症患者血清催乳素(PRL)和促甲状腺激素(TSH)水平与性功能障碍的关系。

材料和方法

这是一项基于医院的横断面研究,纳入了 118 名年龄在 18-57 岁之间(55 名男性,63 名女性)的患者,均确诊为精神分裂症。所有患者在抗精神病药物治疗后均稳定。检测静脉血中的激素水平,包括催乳素(PRL)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮、睾酮、促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)。采用阳性和阴性症状量表(PANSS)评分评估精神分裂症患者的症状严重程度。采用 5 项中文简体版亚利桑那性体验量表(ASEX)评估性功能。

结果

有 66 名患者(55.9%)存在高催乳素血症,性功能障碍组的高催乳素血症患病率明显高于非性功能障碍组(91.8% vs. 17.5%)(P<0.001)。与无性功能障碍的患者相比,有性功能障碍的患者催乳素水平明显升高(P<0.001),且女性患者的发生率更高。亚临床甲状腺功能减退和高催乳素血症与性功能障碍独立相关,PANSS 阴性评分升高是性功能障碍发生的独立危险因素。

结论

精神分裂症患者的性功能障碍发生率显著升高。高催乳素血症和亚临床甲状腺功能减退与性功能障碍相关,尤其是女性患者。

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