精神分裂症住院病人应用阿立哌唑致锥体外系症状的影响因素

The influence factors of aripiprazole-induced extrapyramidal symptoms in patients with schizophrenia

目的探讨阿立哌唑治疗精神分裂症病人时锥体外系症状(EPS)的发生率及相关影响因素。方法选取2014年3月至2018年12月于芜湖市第四人民医院309例单独服用阿立哌唑治疗的精神分裂症病人作为纳入对象,通过其资料进行回顾性研究,收集人口学特征、临床特征及用药情况等,将其分为EPS组和非EPS组进行比较,采用logistic分析相关影响因素。结果所有纳入病人中EPS的发生率为17.80%。EPS组与非EPS组在年龄[(31.75±9.52)岁比(36.84±12.92)岁,Z=3.353,P=0.001]、病程[50(14,98)月比72(25,132)月,Z=2.807,P=0.005]、最大服药剂量[(19.82±4.51)mg比(17.93±3.29)mg,Z=2.943,P=0.004]、每公斤体质量服药剂量[(0.344±0.086)mg比(0.294±0.057)mg,Z=4.120,P<0.001]及服药季节(χ^2=16.88,P=0.001)等方面均差异有统计学意义。二分类logistic回归显示年龄及既往服用抗精神病药物与EPS的发生呈显著的负相关性(OR=0.953,P=0.003;OR=0.279,P=0.001),而最大服药剂量与每公斤体质量服药剂量与EPS的发生呈显著的正相关性(OR=1.114,P=0.034;OR=3.875,P=0.029),夏季服药出现EPS的风险性也显著增高(P<0.05)。结论临床上阿立哌唑所致EPS并不少见;年龄、每公斤体质量服药剂量及服药季节是影响EPS发生的重要因素。

Objective To investigate the incidence and influence factors of aripiprazole?induced extrapyramidal symptoms(EPS)in patients with schizophrenia.Methods The demographic characteristics,clinical features and drug application of 309 patients with schizophrenia treated with aripiprazole alone at The Fourth People’s Hospital of Wuhu from March 2014 to December 2018 were collected retrospectively for the study.They were assigned into EPS group and non?EPS group,then the influence factors were analyzed by logistic analysis.Results The incidence of EPS in all patients was 17.80%.There were significant differences in terms of age[(31.75±9.52)years old vs.(36.84±12.92)years old,Z=3.353,P=0.001],duration of disease[50(14,98)months vs.72(25,132)months,Z=2.807,P=0.005],maximum dose[(19.82±4.51)mg vs.(17.93±3.29)mg,Z=2.943,P=0.004],dosage per ki?logram of body weight[(0.344±0.086)mg vs.(0.294±0.057)mg,Z=4.120,P<0.001]and medication season(χ^2=16.88,P=0.001)between the two groups.The binomial logistic regression analysis showed that age and previous use of antipsychotic drugs were negatively correlated with the occurrence of EPS significantly(OR=0.953,P=0.003;OR=0.279,P=0.001),and there was a significant positive correlation between the maximum dose and the dosage per kilogram of body mass and the occurrence of EPS(OR=1.114,P=0.034;OR=3.875,P=0.029).The EPS risk due to drug use was also increased significantly in summer(P<0.05).Conclusions The aripiprazole?induced EPS is not uncommon in clinical practice.Age,dosage per kilogram of body weight and medication season might be the the important factors affecting the occurrence of EPS.