利培酮或传统抗精神病药长期治疗对精神分裂症QTc间期影响

Impact of long-term treatment with risperidone or typical antipsychotics on QTc in schizophrenic patients

目的:探讨利培酮与传统抗精神病药长期治疗的精神分裂症患者心电图校正QT间期(corrected QT interval,QTc)差异及相关因素。方法:将服用利培酮(n=44)或传统抗精神病药(n=44)12个月以上的精神分裂症患者纳入研究,检测心肌酶等生化指标及心电图,按Bazett's公式计算QTc间期,以QTc>440 ms作为QTc间期延长标准。用直线相关分析和直线回归分析法分析QTc间期与其他因素之间的关系。结果:利培酮组QTc间期(398.73±23.76)ms较传统抗精神病药物组(413.82±23.21)ms短(P<0.05),利培酮组QTc间期延长发生率(2.27%,1例)低于传统抗精神病药物组(18.18%,8例)(P<0.05)。利培酮组性别、剂量与QTc间期相关(P<0.05);传统抗精神病药物组性别、年龄与QTc间期相关(P<0.05)。结论:利培酮对QTc间期影响较传统抗精神病药小,女性是QTc间期延长危险因素。

Objective： To compare the effects of long-term treatment with risperidone or typical antlpsy- chotics on QTc interval and the relative impacting factors. Methods： Schizophrenic patients, who received maintenance treatment with risperidone （n = 44） or typical antipsychotics （ n = 44） beyond 12 months, were enrolled. QT intervals, myocardial enzymes and other biochemical indexes were measured ; QTc intervals were calculated accord- ing Bazett＇s formula, the diagnostic criterion of QTc prolongation was QTc 〉 440 ms. The relationship between QTc intervals and the relative factors were analyzed by linear correlation and linear regression. Results： QTc intervals （398.73 ±23.76） ms in risperidone group were shorter than those （413.82± 23.21 ） ms in typical antipsychotic group （P 〈 0.05 ）, the QTc prolongation prevalence rate （1/44, 2.27% ） in risperidone group was lower than that （8/44, 18. 18% ） in typical antipsychotic group. QTc intervals were correlated with gender and dosage （ P 〈 0.05） in risperidone group ; while they were correlated with gender and age （P 〈 0.05） in typical antipsychotic group. Conclusion： Risperidone has less effect on QTc intervals than typical antipsychotics, and female is a risk factor of QTc intervals prolongation.