抗精神病药致首发精神疾病QTc 间期变化的相关 因素分析
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苏州市重点学科项目(Szxk201515);苏州市精神疾病临床医学中心项目(Szzx201509)


Analysis of the factors related to the QTc interval changes in the first-episode mental disorders treated with antipsychotics
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    摘要:

    目的 调查抗精神病药致首发精神疾病QTc间期延长的影响因素。方法 对服用稳定 剂量抗精神病药治疗1月的309例首发精神疾病患者进行回顾性调查,收集人口学资料、空腹血糖、血 压、血脂等生化指标、心电图资料,以QTc≥ 440 ms作为QTc间期延长的标准,分析QTc间期延长的状 况及其相关因素。结果 QTc间期延长的发生率为10.6%。药物治疗组QTc间期均值大于基线期,差异 有统计学意义(P < 0.05);药物联合电休克治疗组以及药物联合脑电治疗组QTc间期与基线期相比,差 异无统计学意义(P> 0.05)。单一抗精神病药治疗组QTc间期与基线期差异无统计学意义(P> 0.05);而 抗精神病药联用以及抗精神病药联用抗抑郁药/心境稳定剂组QTc间期均值大于基线期,差异有统计 学意义(P < 0.05)。抗精神病药等效氯丙嗪剂量< 1 000 mg/d组别QTc间期与基线期相比差异有统计学 意义(P < 0.05)。抗精神病药剂量与QTc间期没有相关性。女性是QTc间期延长的风险因素(OR=3.26, 95%CI=1.050~10.094),其他因素未进入回归方程。结论 首发精神疾病患者抗精神病药治疗期间QTc间 期延长存在性别差异,女性发生QTc间期延长的风险是男性的3.26倍。药物联用延长的QTc间期并未达 到异常值。抗精神病药剂量与QTc间期没有相关性。除了性别因素外,其他指标不是QTc间期延长的风 险因素。

    Abstract:

    Objective To investigate the prolongation and related factors of antipsychotic drugs on QTc interval in first-episode mental disorders. Methods A retrospective study of 309 first-episode patients with mental disorders treated with one month stable dosage of antipsychotics was conducted. The demographic data, the electrocardiograms(ECG) data, fasting blood glucose, blood pressure, blood lipids and other biochemical indicators were collected, and the prolonged QTc interval and its related factors were analyzed with QTc ≥440 ms as the standard of QTc prolongation. Results The incidence of QTc interval prolongation was 10.6%. The mean value of QTc interval in the drug treatment group was higher than the baseline period, with statistical difference (P<0.05). There was no significant difference in QTc interval either in the drug combined electroconvulsive therapy group or drug combined electroencephalography treatment group compared with the baseline period( P>0.05). Also there was no significant difference in QTc interval between the single antipsychotic group and the baseline (P>0.05). The mean value of QTc interval either in the combination of antipsychotics or antipsychotics combined with antidepressants/mood stabilizers was higher than baseline, and the difference was statistically significant (P<0.05). There was significant difference in the QTc interval between the antipsychotic equivalent chlorpromazine dose( <1 000 mg/d) group and the baseline period( P<0.05). There was no correlation between antipsychotic dosage and QTc interval. The gender of female were a risk factor of QTc prolongation( OR=3.26,95%CI=1.050-10.094), and other factors were not included in the regression equation. Conclusions There is a gender difference in the QTc interval prolongation during antipsychotic treatment for first-episode mental disorders, and the risk of QTc prolongation in female is 3.26 times greater than male that in. The prolongation of the QTc interval of drug combination does not reach the abnormal value. There is no correlation between antipsychotic dosage and QTc interval. In addition to gender factors, other parameters are not the risk factors of QTc prolongation.

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吕笑丽 王碧馨 满丽娟 殷铭 袁念 李哲 杜向东.抗精神病药致首发精神疾病QTc 间期变化的相关 因素分析[J].神经疾病与精神卫生,2017,17(9):
DOI :10.3969/j. issn.1009-6574.2017.09.008.

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  • 在线发布日期: 2018-01-11