迟发性运动障碍与急性锥外系反应

Tardive dyskinesia and acute extrapyramidal side effects

目的：探讨抗精神病药所致的迟发性运动障碍（ＴＤ）的相关因素。方法：用不自主运动量表（ＡＩＭＳ），锥体外系副反应量表（ＲＳＥＳＥ）评定确认ＴＤ、急性锥体外系副反应（ＥＰＳ）存在，建立对照组。对所得临床资料进行统计学分析。结果：ＴＤ组年轻男性多，总服药时间长，服药剂量高，高效价药使用多，既往ＥＰＳ次数多，情感性精神障碍患者服药剂量比精神分裂症患者明显低。ＴＤ严重程度与各临床变量无显著相关性。ＡＩＭＳ≤４分者与＞４分者疗效有显著差异。结论：性别，总服药时间，服药剂量，高效价药，ＥＰＳ次数，情感性精神障碍与ＴＤ的发生密切相关。ＴＤ严重程度可能存在个体易感性。

Objective: To explore the factors associated with tardive dyskinesia (TD) induced by antipsychotics. Method: TD and acute EPS were monitored with the Abnormal Involuntary Movement Scale(AIMS) and Rating Scale for Extrapyramidal Side Effects (RSESE) in patients receiving antipsychotic treatment. Other clinical data were also collected for analysis.HZResults: The occurrence of TD was positively associated with young age, male gender, long period of antipsychotic treatment, high dose, high potency medication, and EPS. The mean antipsychotics dosage was much lower in mood than schizophrenic disorder. There was no relationship between severity of TD and other clinical parameters. The treatment response differed significantly between those with AIMS score <4 and >4. Conclusion: Factors like age, gender, period of drug administration, drug dosage and potency, EPS and diagnosis of mood disorder, are associated with occurrence of TD. Severity of TD also predicts a poor therapeutic response.