第2代抗精神病药物所致锥体外系反应相关因素调查

Investigation on Factors Associated with Extrapyramidal Symptoms Induced by the Second-Generation Antipsychotic Drugs

目的调查第2代抗精神病药物(SGA)所致锥体外系反应(EPS)的相关因素。方法采用随机抽样的观察性横断面方法,纳入年龄18~65岁,且正在使用某一种抗精神病药物的精神分裂症患者,通过Logistic回归分析调查EPS风险与社会人口学、临床特征和药物使用的关系。结果共纳入213例受试者,其中38.02%发生了EPS,EPS发生较多的药物依次为奥氮平(76例,35.68%),利培酮(74例,34.74%),喹硫平(26例,12.21%),齐拉西酮(23例,10.80%);辅助治疗药物中,苯二氮类发生EPS最普遍(67例,31.46%),其次是卡马西平(52例,24.41%)和抗抑郁药(43例,20.19%);多变量分析显示,EPS风险与卡马西平的使用相关[OR=3.677,95%CI(1.627,8.310)];本研究中未发现SGA类别与EPS关联的证据。结论 EPS为SGA使用中常见不良反应,所纳入的不同抗精神病药物所致EPS发生率无显著性差异。卡马西平辅助SGA治疗精神分裂症可能增加EPS发生风险。

Objective To investigate the factors associated with extrapyramidal symptoms（ EPS） induced by the second-generation antipsychotic drugs（ SGA）.Methods The patients with schizophrenia who were using a certain antipsychotic drug between the age of 18 and 65 were selected by the randomized,observational cross-sectional method.The relationship between EPS risk and socio-demography,clinical characteristics and drug use was investigated by Logistic regression analysis.Results Totally 213 subjects were enrolled,of whom 38.02% had EPS.In terms of drugs,76 patients（ 35.68%） were treated with olanzapine,74 patients（ 34.74%） were treated with risperidone,26 patients（ 12.21%） were treated with quetiapine,and 23 patients（ 10.80%） were treated with ziprasidone.In schizophrenia adjuvant drugs,benzodiazepines were most commonly found with EPS（ 67 case,31.46%）,followed by carbamazepine（ 52 cases,24.41%） and antidepressants（ 43 cases,20.19%）.Multivariate analysis showed that the risk of EPS correlated with the use of carbamazepine[ OR = 3.677,95% CI（ 1.627,8.310） ].No evidence of association of SGA with EPS was found in this study.Conclusion EPS is a common adverse reaction in the use of SGA.The incidence rate of EPS induced by different antipsychotic drugs included in this study was not significantly different.Carbamazepine assisted SGA in the treatment of schizophrenia may increase the risk of EPS.