非典型抗精神病药物对首发儿童精神分裂症心电图QT间期的影响

Effects of Atypical Antipsychotic on QT Interval on First-episode Childhood Schizophrenia Patients

目的评价新型非典型抗精神病药物对首发儿童精神分裂症患者心电图QT间期的影响。方法对237例单一口服非典型抗精神病药物治疗的首发儿童精神分裂症患者,分别在治疗前及治疗药物达到临床最大剂量时进行心电图检查,对心电图QT/QTC间期进行对比分析。结果非典型抗精神病药物奥氮平、喹硫平、利培酮、氯氮平、齐拉西酮治疗前后QT/QTC间期比较,差异均无显著性(P>0.05)。齐拉西酮治疗后QT较治疗前显著延长(t=-4.307,P=0.000)。齐拉西酮治疗后QTC较治疗前相比,虽然有延长,但无显著性差异(t=-0.786,P=0.439)。不同组药物治疗后QT/QTC间期平均值长短顺序依次为:齐拉西酮>利培酮>奥氮平>喹硫平>氯氮平。不同药物组治疗前后QTC间期无显著性差异(F=1.477,P=0.208),不同药物组间差异无显著性(F=0.179,P=0.673)。不同药物组治疗前后QT间期无显著性差异(F=2.833,P=0.090),不同药物组间差异有显著性(F=4.929,P=0.001)。结论不同的非典型抗精神病药物对儿童精神分裂症患者心电图QT/QTC间期有不同的影响。其中齐拉西酮组的QT/QTC间期最长,氯氮平组最短,无QTC间期延长达到异常标准的病例。

Objective To evaluate the effects of newer atypical antipsychotic on Electrocardiogram QT interval of patients with first-episode childhood schizophrenia.Methods This study included 237 first-episode childhood schizophrenia patients who were treated with single oral atypical antipsychotic.Electrocardiogram was inspected before treatment and at the clinical maximum dose after treatment respectively.QT/QTC interval was analyzed.Results There weren’t significant differences on QT/QTC interval before and after treatment with Olanzapine,Quetiapine,Risperidone,Clozapine and Ziprasidone（P〉0.05）.QT interval was significantly prolonged after treatment with Ziprasidone（t=-4.307,P=0.000）.QTC interval was prolonged after treatment with Ziprasidone,although the difference was not significant（t=-0.786,P=0.439）.QT/QTC interval length（mean value）after treatment was：Ziprasidone 〉 Risperidone 〉 Olanzapine 〉 Quetiapine 〉 Clozapine.There wasn’t significant difference on QTC interval before and after treatment（F=1.477,P=0.208）.There wasn’t significant difference on QTC interval among treatment groups（F=0.179,P=0.673）.There wasn’t significant difference on QT interval before and after treatment（F=2.833,P=0.090）.There was significant difference on QT interval among treatment groups（F=4.929,P=0.001）.Conclusion The effects of different atypical antipsychotic on QT/QTC interval of patients with childhood schizophrenia are different.Prolongation of the QT interval is most significant in Ziprasidone group and least in Clozapine group,although the prolonging effects were fallen short of the abnormal standard.