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双相障碍治疗前后催乳素、雌二醇水平的改变 及其与临床疗效的关系
梁伟业陈科于健瑾付卫红冯薇陈大春
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目的 探讨双相障碍治疗前后催乳素(PRL)、雌二醇(E2)水平变化及其与临床疗效的关 联。方法 选取2014年1月—2015年5月收住北京回龙观医院的符合ICD-10标准的双相障碍患者57例(男 36 例,女21 例),其中双相躁狂39 例,双相抑郁18 例。入组后患者接受药物治疗,治疗时间为6 周,采用 汉密尔顿抑郁量表24项版(HAMD-24)评估抑郁症状,采用贝克-拉范森躁狂量表(BRMS)评估躁狂症状。 使用化学发光免疫分析法检测研究对象周围血中E2、PRL水平。结果 与基线相比,治疗后双相障碍患 者PRL浓度降低,差异有统计学意义(P=0.01),E2浓度未见明显升高(P>0.05)。双相躁狂组PRL水平降 低,差异有统计学意义(P=0.01)。双相抑郁组PRL、E2浓度变化均不明显(P>0.05)。双相躁狂组治疗前 BRMS评分及双相抑郁组治疗后HAMD-24评分均下降,差异有统计学意义(均P<0.01)。躁狂组治疗前 PRL水平与BRMS评分呈正相关(r=0.41,P<0.01),躁狂组治疗前后PRL变化值及E2变化值与BRMS减分 值呈正相关(r=0.39,P<0.01;r=0.33, P=0.03)。结论 双相障碍、躁狂发作患者治疗后PRL均下降,躁狂 发作患者的症状、疗效与PRL水平的变化可能存在一定相关性。
基金项目:首都卫生发展科研专项项目(首发2018-2-2131)
Changes of estradiol and prolactin levels before and after treatment and their correlation with clinicalefficacy in bipolar disorder patients
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Abstract:
Objective To investigate the changes of estradiol( E2) and prolactin( PRL) levels before and after treatment and their relationship with clinical efficacy in bipolar disorder patients. Methods A total of 57 patients( 36 male, 21 female) who met the diagnostic criteria of international disease classification (Tenth Edition)( ICD-10) for bipolar disorder in Beijing Huilongguan Hospital from January 2014 to May 2015 were recruited, among which there were 39 cases of bipolar mania and 18 cases of bipolar depression. After admission, patients were treated with drugs for 6 weeks. Depressive symptoms were assessed by Hamilton Depression Scale-24 items( HAMD-24), and manic symptoms were assessed by Bech-Rafaelsen Mania Rating Scale( BRMS). The serum E2 and PRL levels in peripheral blood were detected by chemiluminescence immunoassay. Results Compared with the baseline, the PRL level decreased after the treatment, and the difference was statistically significant( P=0.01), while there was no significant increase in E2( P>0.05). The PRL of the mania phase group decreased, and the difference was statistically significant( P=0.01). The changes in PRL and E2 of the depression phase group were not significant( P>0.05). After the treatment, the BRMS score of mania phase group and HAMD score of depression phase group were statistically decreased, and the differences were statistically significant( P < 0.01). A positive correlation was found between PRL levels and scores of BRMS before treatment in mania phase group( r=0.41,P< 0.01). The change level of PRL and E2 before and after treatment in mania phase group was positively correlated with the reduction of BRMS score (r=0.39,P < 0.01;r=0.33,P=0.03). Conclusions PRL level decreased after the psychiatric medicine treatment in bipolar disorder patients and mania phase patients. There is a correlation between the level of PRL and the manic symptoms and curative effect.

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