抗精神病药物致迟发性肌张力障碍12例临床分析及随访研究

Clinical Characteristics and Follow-up Study of 12 Patients with Tardive Dystonia Caused by Antipsychotics

目的：探讨抗精神病药物致迟发性肌张力障碍（TDt）的临床特征及长期结局。方法：应用自制调查表,对12例TDt患者的一般人口学资料、家族史、既往史、精神疾病的诊断、药物相关资料、TDt相关资料、治疗情况及出院时疗效进行调查。采用定期随访的研究方法对患者进行2-28年的长期随访。结果：TDt男性多见,66.67%的患者既往曾出现急性肌张力障碍,典型及非典型抗精神病药物均可引起,出现TDt距开始用药的时间为1-6年,平均（3.71±1.66）年。TDt可累及身体的任何部位,而以头颈部最常见,向右侧斜颈较多见。本研究12例患者均停用致病药物,曾试用多种药物治疗,在2-28年随访期间,无一例恢复,且5例述有疼痛感。结论：TDt有其自身临床特征,病程具有持续性的特点,一旦发生,症状常持续存在。

Objective：To explore the clinical characteristics and long-term outcome of tardive dystonia （TDt）caused by antipsychotics. Methods：A self-made questionnaire was used to obtain information of 12 patients with TDt. The content of questionnaire included demographic data, family history, past history, drug-related data, tardive dystonia-related data, treatment-related data and outcome. A 2 - 28 year follow-up study was conducted on all the patients. Results：TDt was more common in males and 66.67% patients have a history of acute dystonia which may be caused by typical or untypical antipsychotics. The onset of TDt occurred in 1 - 6 years after drug treatment. TDt could involve any part of a body mostly in cranial, neck region and right-sided torticollis. None of the patients recovered after suspending causative drugs but trying other therapeutic agents. Condusion：TDt has its own clinical characteristics such as persistent course and existence of symptoms once TDt occurred.