摘要
目的探讨精神疾病患者接受奥氮平单药或与其他非典型抗精神病药物联合用药治疗后,甲状腺激素水平的变化,并比较两种治疗方案之间的差异。方法回顾44例接受奥氮平治疗的住院精神疾病患者的病例,其中24例接受单药治疗,20例接受多药联合治疗,比较治疗前后甲状腺激素水平的差异。结果治疗后,单药组中游离四碘甲状腺原氨酸(FT4)、总四碘甲状腺原氨酸(TT4)血清水平降低,促甲状腺激素(TSH)水平升高,与治疗前比较差异有统计学意义(相对于基线变化值的中位数:FT4:-2.86 pmol/L,P<0.001;TT4:-22.09 nmol/L,P=0.002;TSH:0.97 mIU/L,P<0.001)。联合用药组中游离三碘甲状腺原氨酸(FT3)、总三碘甲状腺原氨酸(TT3)、FT4和TT4的血清水平均降低,TSH血清水平升高,与治疗前相比,差异有统计学意义(相对于基线变化值的中位数:FT3:-0.34 pmol/L,P=0.022;TT3:-0.17 nmol/L,P=0.049;FT4:-1.28 pmol/L,P=0.001;TT4:-12.31 nmol/L,P=0.028;TSH:1.59 mIU/L,P=0.012)。两组患者亚临床甲状腺激素功能减退的发生率分别为4.2%、20.0%,两组比较差异无统计学意义(P=0.242)。结论为了避免甲状腺激素水平异常引起其他的疾病,应关注接受奥氮平治疗的精神疾病患者的甲状腺激素水平。
Objective To study the changes in serum thyroid hormone levels in psychiatric patients after olanzapine monotherapy or polytherapy treatment,and to compare the differences between the two treatment regimens.Methods The medical records of 44 inpatients were retrospectively reviewed,of which 24 patients received olanzapine monotherapy treatment,and 20 patients received olanzapine polytherapy treatment.Thyroid hormone levels of patients before and after treatment,and the differences between the two treatment regimens were compared.Results After olanzapine monotherapy treatment,serum levels of FT4 and TT4 were significantly decreased,and serum TSH levels were increased,and the difference was statistically significant(changes from baseline:FT4-2.86 pmol/L,P<0.001;TT4-22.09 nmol/L,P=0.002;TSH 0.97 mIU/L,P<0.001).After olanzapine polytherapy treatment,serum levels of FT3,TT3,FT4 and TT4 of patients were decreased,while serum TSH levels were increased(changes from baseline,FT3-0.34 pmol/L,P=0.022;TT3-0.17 nmol/L,P=0.049;FT4-1.28 pmol/L,P=0.001;TT4-12.31 nmol/L,P=0.028;TSH 1.59 mIU/L,P=0.012).The incidence of subclinical thyroid dysfunction of the monotherapy group and polytherapy group were 4.2%and 20%,respectively,and there was no significant difference between the two treatment regimens(P=0.242).Conclusion To avoid other adverse reactions caused by abnormal thyroid hormone levels,attention should be paid to changes in serum thyroid hormone levels in psychiatric patients receiving olanzapine treatment.
作者
张嘉萱
杨双双
邓顺顺
邱玛丽
ZHANG Jia-xuan;YANG Shuang-shuang;DENG Shun-shun;QIU Ma-li(Zhongshan Third People’s Hospital,Zhongshan 528451,China)
出处
《实用药物与临床》
CAS
2020年第10期901-904,共4页
Practical Pharmacy and Clinical Remedies
基金
中山市医学科研项目(2018J164)。
