TETs评估抗精神病药物对心血管功能影响的研究

Study on the application of TETs to evaluate the effects of antipsychotic drugs on cardiovascular function

目的探讨应用TETs评估服用抗精神病药物对患者心功能影响的作用,为临床合理应用抗精神病药物提供依据,并尽早发现患者潜在心功能障碍。方法选择杭州市第七人民医院2011年12月—2013年2月收治的100例服用利培酮片、喹硫平片、奥氮平片、阿立哌唑片及齐拉西酮胶囊进行治疗的患者作为研究对象,每组各20例,于患者服药前及服药1周、2周、3周后采用Bruce方案进行TETs,测定其达到亚极量心率所用时间或自感筋疲力尽所需时间,并记录服药后不良反应情况。结果服药前及服药1周后,各组患者达到亚极量心率时间及终止试验时自我疲劳等级差异无统计学意义(P>0.05),服药2周及3周后各组患者达到亚极量心率时间显著降低,终止试验时自我疲劳等级显著增高(P<0.05),差异具有统计学意义。利培酮组较之其他组,组间差异具有统计学意义(P<0.05)。并且利培酮组患者2周及3周后TETs阳性率也显著高于其他组患者,差异具有统计学意义(P<0.05)。不良反应方面,奥氮平组血糖、血脂升高与其他组差异有统计学意义(P<0.05),利培酮组血性激素水平显著高于其他组(P<0.05),差异具有统计学意义。结论 TETs可有效评估抗精神病药物对心血管功能的影响,尽早发现潜在心功能障碍,指导临床合理用药。

Objective To investigate the application of TETs to evaluate the effects of antipsychotic drugs on cardiac func- tion in patients, and to provide the basis for the rational clinical use of antipsychotic drugs and discover the potential pa- tients earlier. Methods From December 2011 to February 2013,100 patients with antipsychotic drugs of our hospital were treated as the research object. The patients took TET following the BRUCE scheme before and after the treatment for 1 week,2 weeks,3 weeks, whose time of the submaximal heart rate or time of self fatigue. Besides, the adverse reactions of patients after taking the pills were recorded. Results Before and after the treatment 1 week, patients in each group the time of submaximal heart rate and termination test self fatigue level had no significant difference（ P 〉 0.05 ）. But after 2 and 3 weeks, the patients achieved submaximal heart rate time reduced significantly and self fatigue level significantly in- creased （ P 〈 0.05 ）, with statistical significance. Conclusion TETs can evaluate antipsychotic drugs on cardiovascular function effectively, we should discover the potential cardiac dysfunction as soon as possible and guide the clinical rational drug use.