身心醫學科病患發生高泌乳激素血症之相關研究

Research on the Occurrence of Hyperprolactinemia in Patients in the Department of Psychosomatic Medicine

林淑靜(Shu-Ching Lin) ； 莊紫翎(Tzyy-Ling Chuang) ； 廖建國(Jian-Guo Liao) ； 張素雲(Su-Yun Chang) ； 薛伃婕(Yu-Chieh Hsueh) ； 王昱豐(Yuh-Feng Wang)

《核子醫學暨分子影像雜誌》 33卷4期 (2020/12) Pp. 244-253

https://doi.org/10.6332/ANMMI.202012_33(4).0003

摘要

背景：高泌乳激素血症是女性常見的內分泌相關疾病，引起高泌乳激素血症的原因分為病理性、生理性或因服用藥物造成。當泌乳激素發生異常時，將會造成內分泌系統中腦下垂體相關賀爾蒙異常引發相關臨床症狀，部分藥物將會造成血中泌乳激素異常升高且引起不良反應，因此本篇研究主要探討抗精神病藥物於身心醫學科病患服藥後發生高泌乳血症的患病率，並評估性別、年齡與泌乳激素之相關性研究。材料與方法：本篇為回顧性研究，收集2014年1月至2019年3月於本院接受泌乳激素檢查的患者之病歷紀錄，共計收集5,001位受檢者，其中正常組4,497位及異常組504位。於排除病歷紀錄不完整之病人後，最終收集331位身心醫學科高泌乳激素受檢者資料，男性為42名（13%），女性為289名（87%）。高泌乳血症之定義為血清中的泌乳激素數值男性＞26.90ng/mL，女性＞37.20ng/mL。結果：經過統計分析發現泌乳激素數值於性別間達統計差異（p＜0.001）。近一步將泌乳激素數值於不同科別受檢者個別分析發現，身心醫學科（p＜0.001）於性別間達統計差異，並於此身心醫學科患者中，正常與異常之年齡差異（p＜0.017）達統計差異，其中泌乳激素異常組中性別對於年齡（p=0.286）與泌乳激素數值（p＜0.001）間也有差異。此外也將泌乳激素異常組分成＜45歲與≥45歲女性分析達統計差異（p=0.001）。最終利用簡單線性迴歸分析單獨統計≥45歲女性泌乳激素數值為負相關（-0.195）且達統計差異（p=0.017）。結論：身心醫學科服用抗精神病用藥的病人發生高泌乳血症的機率高於其他科別，此類抗精神病藥的副作用嚴重影響病人的日常，往往造成身心醫學科患者用藥依從性降低，甚至中斷服用，導致治療效果降低或是精神疾病復發，因此監控身心醫學科病患的泌乳激素具有必要性。

關鍵字

抗精神病藥物 ； 高泌乳激素血症 ； 泌乳激素

並列摘要

Background: Hyperprolactinemia is a common endocrine-related disease in women. The causes of hyperprolactinemia can be divided into pathologically, physiologically, or drug-induced. When the serum prolactin level is abnormal, the change of pituitary gland-related hormone in the endocrine system will cause related clinical symptoms. Certain drugs will lead the serum prolactin abnormally elevated and then adverse reactions might be developed. This research aimed to discuss the prevalence of hyperprolactinemia after taking antipsychotics in the department of psychosomatic medicine and to evaluate the correlation between sex, age, and prolactin. Methods: This is a retrospective study and medical records of patients who underwent prolactin examinations in our hospital from January 2014 to March 2019 were collected. A total of 5,001 subjects were collected, 4,497 in the normal group and 504 in the abnormal group, depending on the serum prolactin level. Patients with incomplete medical records were excluded. Finally, the data of 331 subjects with high prolactin levels in the department of psychosomatic medicine were collected, 42 male (13%) and 289 female (87%). Hyperprolactinemia was defined as the serum prolactin level over 26.90 ng/mL in male and 37.20 ng/mL in female. Results: After statistical analysis, it was found that the value of prolactin reached a statistical difference between male and female subjects (p ＜ 0.001). Further analysis of the value of prolactin among subjects in different disciplines found that subjects in the department of psychosomatic medicine were statistical differences (p ＜ 0.001). In those psychosomatic medicine subjects, the statistical difference between normal and abnormal age (p ＜ 0.017) was revealed, and the difference between gender and age (p = 0.286) and the value of prolactin (p ＜ 0.001) were also noted. In addition, the abnormal prolactin level subjects were analyzed into females ＜ 45 years old and ≥ 45 years old, the statistical differences (p = 0.001) were also presented. Finally, a simple linear regression analysis was used to separately count the prolactin values of women ≥ 45 years old, which were negative correlated (-0.195) and were statistical differences (p = 0.017). Conclusions: Patients in the department of psychosomatic medicine taking antipsychotics are more likely to develop hyperprolactinemia than other departments. The side effects of taking antipsychotics seriously affect the daily routine of the patients and often cause the patients in the department of psychosomatic medicine to reduce their medication compliance and even interrupt their medication, resulting in the treatment effect reduced or the mental illness recurring, so it is necessary to monitor the prolactin of patients in the psychosomatic medicine department.

並列關鍵字

antipsychiatric drugs ； hyperprolactinemia ； prolactin