三种药物对精神分裂症患者心肌酶及心电图异常率的影响

Influence of three antipsychotic drugs on myocardial enzymes,electrocardiogram abnormal rate in patients with schizophrenia

目的探讨氨磺必利、氯氮平及阿立哌唑对精神分裂症患者心肌酶及心电图异常率的影响。方法选取精神分裂症患者150例,以随机数字表法分为A组(50例)、B组(50例)及C组(50例),分别采用氨磺必利、氯氮平及阿立哌唑治疗;比较三组患者治疗前后谷草转氨酶(glutamic-oxalacetic transaminase,AST)、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)、α-羟丁酸脱氢酶(alphahydroxybutyric dehydrogenase,α-HBDH)及随访心电图异常率等。结果三组患者治疗前后AST、CK-MB及LDH比较差异无统计学意义(P>0.05);三组患者治疗后CK和α-HBDH水平显著高于治疗前(P<0.05);A、C组患者随访心电图异常率显著低于B组(P<0.05);A组和C患者随访心电图异常率比较差异无统计学意义(P>0.05)。结论氨磺必利、氯氮平及阿立哌唑治疗精神分裂症均可产生心脏毒性,但氯氮平较氨磺必利、阿立哌唑更易出现心电图异常。

Objective To investigate the influence of amisulpride,clozapine and aripiprazole on myocardial enzymes,electrocardiogram abnormal rate in patients with schizophrenia. Methods A total of 150 patients with schizophreni was selected from June 2014 to June 2016 in our hospital and randomly divided into 3 groups,including A group（50 patients）with amisulpride,B group（50 patients）with clozapine and C group（50 patients）with aripiprazole. The levels of AST,CK,CK-MB,LDH and α-HBDH and electrocardiogram abnormal rate were compared before and after treatment in each group. Results There was no significant difference in the levels of AST,CK-MB and LDH before and after treatment（P〈0.05）. The levels of CK andα-HBDH after treatment of 3 groups were significantly higher than before treatment（P〈0.05）. The electrocardiogram abnormal rate of A group and C group was significantly lower than C group（P〈0.05）. There was no significant difference in electrocardiogram abnormal rate between A group and C group（P〈0.05）. Conclusion Amisulpride,clozapine and aripiprazole in the treatment of patients with schizophrenia can cause the cardiac toxicity. Compared with amisulpride and aripiprazole,clozapine has higher risk of ECG abnormality.