抗精神病药对精神分裂症患者QTc间期的影响

Influence of antipsychotic drugs on QTc interval in patients with schizophrenia

目的探讨抗精神病药物联合应用对精神分裂症患者QTc间期(QT间期是心电图自QRS波开始至T波终结时的时间段,QTc间期是按心率校正的QT间期)的影响。方法选取69例精神分裂症患者,按照用药剂量将患者分为低剂量组(≤200 mg·d^(-1))、中剂量组(>200~500 mg·d^(-1))和高剂量组(>500 mg·d^(-1)),每组各23例,根据用药种类将患者分为3组:15例单药组、26例两药组和28例多药组。比较使用抗精神病药物前后患者QTc间期及血液学指标的变化。结果治疗前后,3组患者的血液学指标比较差异均无统计学意义(P>0.05),治疗前,3组患者的QTc间期比较差异无统计学意义(P>0.05);治疗后,3组患者的QTc间期均有不同程度地增高(P<0.05),与低剂量组比较,中、高剂量组的QTc间期明显增高(P<0.05),与中剂量组比较,高剂量组的QTc间期明显增高(P<0.05),与单药组比较,两药组的QTc间期明显增高(P<0.05),与两药组比较,多药组的QTc间期明显增高(P<0.05)。各组总不良反应发生具有抗精神病药剂量增多及用药种类增多的依赖性增加趋势。结论抗精神病类药物可延长精神分裂症患者的QTc间期,QTc间期延长程度与给药剂量较高及多种药物联合应用有关。

Objective To investigate the effect of combined application of antipsychotic drugs on QTc interval(QT interval is to measure the interval ECG from the beginning of QRS wave to the end of T wave,QTc is the QT interval corrected by heart rate)in patients with schizophrenia.Methods 69 patients with schizophrenia were selected and divided into 3 groups according to the dosage:the low-dose group(≤200 mg·d^(-1)),the medium-dose group(>200-500 mg·d^(-1))and the high-dose group(>500 mg·d^(-1)),23 patients in each group.And the patients were divided into 3 groups according to the type of medication at the same time:15 cases in the single-drug group,26 cases in the double-drug group and 28 cases in the multi-drug group.The changes of QTc interval and hematological parameters among the patients before and after the use of antipsychotic drugs were compared.Results Before and after treatment,there was no statistically significant difference in hematological parameters among the 3 groups(P>0.05).Before treatment,there was no significant difference in QTc among the 3 groups(P>0.05).After treatment,the QTc increased to varying degrees(P<0.05).Compared with the low-dose group,the QTc of the medium and the high-dose groups significantly increased(P<0.05).Compared with the medium-dose group,the QTc of the high-dose group significantly increased(P<0.05).Compared with the single-drug group,the QTc of the double-drug and multi-drug groups significantly increased(P<0.05).Compared with the double-drug group,the QTc of the multi-drug group significantly increased(P<0.05).The occurrence of total adverse reactions in each group showed an increasing trend of doses and increasing types of medications.Conclusion Antipsychotic drugs can prolong the QTc interval in patients with schizophrenia.The degree of QTc interval prolongation is related to the higher dose and the combination of multiple drugs.