利培酮对首发精神分裂症未经治疗患者心电图的影响

Effects of risperidone on electrocardiogram in drug-naive patients with first-episode schizophrenia

目的:观察利培酮对首发精神分裂症未经治疗患者心电图的影响。方法:2004年1月至2008年12月首发精神分裂症未经治疗住院患者95例纳入研究,其中男40例,女55例,平均年龄(33.85±10.80)岁,年龄<40岁者72例,40～70岁者23例;病程≥5年者32例(33.68%),病程<5年者63例(66.32%)。利培酮起始剂量为1 mg,1次/d口服,2周内逐渐增加剂量至2～6 mg,1次/d,连续服药3个月。服用利培酮低剂量(<4 mg/d)者32例,高剂量(≥4 mg/d)者63例。于服药前、服药后1、2、3个月测定患者心电图变化,观察性别、年龄、病程、给药剂量与心电图改变的关系。结果:利培酮引起的心电图异常主要为窦性心律失常(窦性心动过速、窦性心动过缓及窦性心律不齐),其次为ST-T改变。服药后1、2、3个月心电图异常发生率分别为37例(38.95%)、28例(29.47%)和31例(32.63%)。其中,男性与女性患者分别为19例(47.5%)、14例(35.0%)、12例(30.0%)与18例(32.7%)、14例(25.5%)、19例(34.5%);年龄40～70岁与<40岁患者分别为5例(21.7%)、5例(21.7%)、6例(26.1%)与32例(44.4%)、23例(31.9%)、25例(34.7%);病程≥5年与<5年患者分别为12例(37.5%)、9例(28.1%)、6例(18.8%)与25例(39.7%)、19例(30.2%)、25例(39.7%),低剂量和高剂量患者分别为8例(25.0%)、7例(21.9%)、8例(25.0%)与29例(46.0%)、21例(33.3%)、23例(36.5%)。不同性别、年龄、病程及给药剂量的患者在不同给药时间点的心电图改变差异均无统计学意义(均P>0.05)。结论:利培酮对首发精神分裂症未经治疗患者心电图的影响较轻,是一种心脏毒性较小的抗精神病药物。

Objective： To observed the effects of risperidone on electrocardiogram （ECG） in drug-naive patients with first-episode schizophrenia. Methods：Ninety-five drug-naive inpatients with first-episode schizophrenia between January 2004 and December 2008 were enrolled in the study. The patients comprised 40 men and 55 women with average age of （33.85 ± 10.80） years. Seventy-two patients＇ age was 〈 40 years and 23 patients＇ age was 40-70 years. The disease duration was ≥5 years in 32 cases （33.68%） and 〈5 years in 63 cases （66. 32% ）. The patients started receiving risperidone at an initM dose of 1 mg once daily that was gradually increased to 2-6 mg daily within 2 weeks for a total of 3 months; of them, 32 patients received low-dose risperidone （ 〈 4 mg/d） and 63 patients received high-dose risperidone （≥4 mg/d）. The patients＇ECG was performed before and 1,2, and 3 months after administration. The relationship among sex, age, disease duration, dosage and ECG changes was observed. Results： Risperidone-induced abnormal ECG mainly was sinus arrhythmia including sinus tackycardia, sinus bradycardia, and sinus irregularity, and secondly was ST-T changes. Abnormal ECG occurred respectively in 37 cases （38.95%）, 28 cases （29.47%）, and 31 cases （32.63%） 1,2, and 3 months after administration. Of them, male and female patients were respectively 19 cases （47.5%）, 14 cases （35.0%）, 12 cases （30.0%） and 18 cases （32.7%）, 14 cases （25.5%）, 19 cases （34. 5% ） ; the patients with age of 40-70 years and 〈 40 years were respectively 5 cases （21.7%）, 5 cases （21.7%）, 6 cases （26. 1% ） mad 32 cases （44.4%）, 23 cases （51.9%）, 25 cases （34.7%）; the patients with disease duration of ≥5 years and 〈 5 years were respectively 12 cases （37.5%）, 9 cases （28.1% ）, 6 cases （ 18.8% ） and 25 cases （39.7%）, 19 cases （30.2%）, 25 cases （59. 7% ） ; the patients receiving low-dose and high-dose risperidone were respectively 8 cases （25.0%）, 7 cases （21.9%）, 8 cases （25.0%） and 29 cases （46.0%）, 21 cases （33.3%）, 23 cases （？,6.5%）. There were no differences in ECG changes in different time points among the patients with different sex, age, disease duration, and doses（ all P 〉 0. 05 ）. Collusion： The effects of risperidone on ECG in drug-naive patients with first-episode schizophrenia are mild. It is a less cardiotoxic antipsychotic drug.