3种常用抗精神病药物对精神分裂症患者心肌酶及心电图的影响

Effects of Three Commonly Used Antipsychotics on Myocardial Enzymes and Electrocardiogram in Patients with Schizophrenia

目的分析3种常用抗精神病药物对精神分裂症患者心肌酶及心电图的影响。方法回顾性分析2017年7月—2018年4月淄博市第五人民医院收治的85例精神分裂症患者的病历资料,按照用药差异进行分组,其中A组(氨黄必利组)24例,B组(氯氮平组)30例,C组(阿立哌唑组)31例,比较3组患者治疗前后心肌酶指标及心电图表现。结果B组治疗后AST为(29.3±6.5)IU/L,明显高于治疗前(22.4±6.3)IU/L(P<0.05);A、B、C组治疗后CK水平分别为(127.3±23.6)U/L、(131.2±25.8)U/L、(143.4±32.4)U/L,均明显高于该组治疗前(102.3±34.5)U/L、(102.5±15.9)U/L、(103.5±19.8)U/L(P<0.05);A、B组治疗后α-HBDH分别为(162.5±27.3)U/L、(161.2±23.8)U/L,均明显高于该组治疗前(142.6±24.9)U/L、(141.2±20.6)U/L(P<0.05)。3组患者心电图异常发生率两两比较,差异无统计学意义(A:B=25%:33.33%;A:C=25%:32.26%;B:C=33.33%:32.26%;P>0.05)。结论3种抗精神病药物对精神分裂症患者多项心肌酶指标均存在不同程度的影响,尤其对α-HBDH和CK指标的影响最为显著,对患者心脏功能存在不利影响,应当谨慎用药。

Objective To analyze the effects of three commonly used antipsychotics on myocardial enzymes and electrocardiogram in patients with schizophrenia.Methods A retrospective analysis of the medical records of 85 patients with schizophrenia admitted to the Fifth People's Hospital of Zibo City from July 2017 to April 2018,according to the differences in medication,including group A (Ammonia Bili group),24 cases,30 patients in the group B (clozapine group) and 31 patients in the group C (aripiprazole group).The myocardial enzyme index and electrocardiogram were compared before and after treatment.Results After treatment,the AST was (29.3±6.5) IU/L,which was significantly higher than that before treatment (22.4±6.3) IU/L (P<0.05).The CK levels after treatment in group A,B and C were (127.3±23.6) U/L,(131.2±25.8) U/L,(143.4±32.4) U/L,which were significantly higher than the pre-treatment (102.3±34.5) U/L,(102.5±15.9) U/L,(103.5±19.8) U/L (P<0.05);α-HBDH in group A and B were (162.5±27.3) U/L and (161.2±23.8) U/L,respectively,which were significantly higher than this group before treatment (142.6±24.9) U/L,(141.2±20.6) U/L (P<0.05).There were no significant differences in the incidence of abnormal electrocardiogram between the three groups (A: B = 25%: 33.33%;A: C = 25%:32.26%;B:C = 33.33%: 32.26%;P>0.05).Conclusion Three antipsychotic drugs have different effects on various myocardial enzyme indexes in patients with schizophrenia,especially the α-HBDH and CK indicators,which have adverse effects on the heart function of patients,and should be used with caution.