应用运动平板试验评估利培酮和奥氮平对精神病患者心血管功能的影响

Effect of treadmill exercise test evaluation of Risperidone and Olanzapine on cardiovascular function in patients with psychosis

目的探讨应用平板运动试验评估利培酮和奥氮平对患者心功能的影响，为临床合理用药提供依据。方法选择杭州市第七人民医院2011年12月～2013年2月收治的80例服用利培酮、奥氮平进行治疗的精神分裂症患者作为研究对象，于患者服药前及服药1、2、3周后采用Bruce方案进行运动平板试验，测定其达到亚极量心率所用时间或自感筋疲力尽所需时间，并记录患者服药后不良反应情况。结果服药前及服药1周后，两组患者达到亚极量心率时间及终止试验时自我疲劳等级比较差异无统计学意义（P〉0．05）。而服药2周及3周后两组患者达到亚极量心率时间显著降低，利培酮组2周为（12．02±1．83）min，3周为（10．04±1．67）min，与服药前比较差异有统计学意义（P〈0．05），而奥氮平组2周为（13．97±1．94）min，3周为（12．17±2．12）min，与服药前比较差异有统计学意义（P〈0．05）。两组终止试验时自我疲劳等级显著增高，利培酮组2周为（17．90±3．41），3周为（18．80±2．55），与服药前比较差异有统计学意义（P〈0．05），而奥氮平组2周为（17．00±3．58），3周为（17．10±3．05），与服药前比较差异有统计学意义（P〈0．05）；利培酮组与奥氮平组比较，差异有统计学意义（P〈0．05）。结论运动平板试验可有效评估利培酮和奥氮平对心血管功能的影响，尽早发现潜在的心功能障碍，指导临床合理用药。

Objective To investigate the application of treadmill exercise test （TET） to evaluate the effects of Risperi- done and Olanzapine on cardiac function in patients, which provides the basis for the rational clinical use of antipsy- chotic drugs. Methods 80 schizophrenic patients treated in the Seventh People＇s Hospital of Hangzhou City from De- cember 2011 to February 2013 were chosen as the research objects. The patients took TET following the Bruce scheme before and after the treatment for 1, 2, 3 weeks, whose time of the submaximal heart rate or time of self fatigue. Be- sides, the adverse reactions of patients after taking the pills were recorded. Results Before and after the treatment 1 week, the time of submaximal heart rate and termination test self fatigue level in the two groups had no significant differences （P 〉 0.05）. But after 2 and 3 weeks, the patients achieving submaximal heart rate time reduced significantly, Rsperidone group at 2 weeks was （12.02±1.83） min, （10.04±1.67） rain for 3 weeks, compared to the baseline, there was a significant difference （P 〈 0.05）, while Olanzapine group at 2 weeks was （13.97±1.94） min, （12.17±2.12） min for 3 weeks, compared to the baseline, there was a significant difference （P 〈 0.05）. Self fatigue level significantly increased, Risperi- done group at 2 weeks was （17.90±3.41）, （18.80±2.55） for 3 weeks, compared to the baseline, there was a significant differ- ence （P 〈 0.05）, while Olanzapine group at 2 weeks was （17.00±3.58）, （17.10±3.05） for 3 weeks, compared to the baseline, there was a significant difference （P 〈 0.05）; compared with Olanzapine group, Risperidone group, there was a signifi cant difference （P 〈 0.05）. Conclusion TET can evaluate the affect of Risperidone and Olanzapine on cardiovascular func- tion effectively, discover the potential cardiac dysfunction as soon as possible and guide the clinical rational drug use.