哌罗匹隆联合甲状腺素治疗原发性甲状腺功能减退症所致精神障碍疗效观察

Observation on the curative effects of perospirone combined with thyroxine in the treatment of mental disorders caused by primary hypothyroidism

摘要:

目的：探讨哌罗匹隆联合甲状腺素（thyroxine，T4）治疗原发性甲状腺功能减退症（简称甲减）所致精神障碍的疗效及安全性。方法：使用哌罗匹隆联合T4或左-甲状腺素钠片治疗甲减所致精神障碍34例，采用阳性和阴性症状量表（positive and negative symptom scale，PANSS）及不良反应症状量表（treatment emergent symptoms scale，TESS）于治疗前后进行评定，并在疗程结束后比较治疗前后血促甲状腺激素（thyroid stimulating hormone，TSH）、三碘甲状腺元氨酸（iodine thyroid acid，T3）、T4、游离T3（free iodine thyroid acid，FT3）、游离甲状腺素（free thyroxine，FT4）的变化情况。结果：哌罗匹隆联合Ｔ４或左-甲状腺素钠片治疗后PANSS总分明显下降，治疗前与治疗后第2、4、8周比较差异有统计学意义（P<0.01）。病情疗效评定：总有效率88.2%。治疗后TSH、T3、T4、FT3、FT4明显好转，与治疗前比较，差异有统计学意义（P<0.01）。结论：哌罗匹隆是一种安全有效的抗精神病药物，对精神症状有显著的改善作用。联合T4治疗原发性甲减所致精神障碍病人是安全有效的。

Abstract:

Objective：To explore the curative effects and safety of perospirone combined with thyroxine in the treatment of mental dis－orders caused by primary hypothyroidism. Methods：Totally 34 patients with mental disorders caused by hypothyroidism were treated by perospirone combined with thyroxine（T4）or left-levothyroxine sodium tablets. Positive and negative symptom scale（PANSS） and treatment emergent symptoms scale（TESS） were used to assess the curative effects before and after the treatment. Changes of blood thyroid stimulating hormone（TSH），iodine thyroid acid（T3），T4，free iodine thyroid acid（FT3） and free thyroxine（FT4） before and after the treatment were compared. Results：PANSS total scores were decreased significantly after treatment of perospirone com－bined with T4 or left-levothyroxine sodium tablets，with significant statistical differences before the treatment and at 2，4，8 weeks after the treatment（P<0.01）. Disease efficacy evaluation：the total effective rate was 88.2%. After the treatment，TSH，T3，T4，of FT3 and FT4 were significantly improved compared with those before treatment（P<0.01）. Conclusions：Perospirone is a safe and effective antipsy－chotic medication and can make significant improvement in psychiatric symptoms. Perospirone combined with thyroxine is safe and ef－fective in the treatment of mental disorders caused by primary hypothyroidism.