抗精神病药物导致QTc间期延长影响因素的研究进展

Research progress on QTc interval prolongation caused by antipsychotics and its influencing factors

精神分裂症患者与一般人群相比,心血管疾病死亡风险明显升高,这与抗精神病药物的使用有一定的关系.抗精神病药物导致QTc间期延长,增加了室性快速心律失常或尖端扭转型室性心动过速(TdP)的发生风险,严重者可恶化为致命的心室颤动,甚至心脏性猝死(SCD).性别、年龄和电解质紊乱对QTc间期延长均有影响;不同抗精神病药物对QTc间期的影响不同;单一抗精神病药物治疗和多种抗精神病药物联合治疗对QTc间期的影响也不同;抗精神病药物导致的QTc间期延长也受到遗传因素的影响,随着药物遗传学的发展,许多与抗精神病药物导致QT间期延长的相关基因被鉴定出来.现就抗精神病药物导致QTc间期延长影响因素的研究进展予以综述,以期为临床诊疗提供参考.

Compared with the general population,the risk of cardiovascular death for schizophrenia patients is significantly higher,which is partly related to the use of antipsychotic drugs.Antipsychotic drugs increase the risk of life-threatening pleomorphic ventricular tachyarrhythmia or torsade de pointes(TdP)by prolonging QTc interval.Severe cases may deteriorate into fatal ventricular fibrillation or even sudden cardiac death(SCD).Gender,age and electrolyte disturbance all have effects on QTc interval prolongation.Different antipsychotic drugs have different effects on QTc interval prolongation.The effects of single antipsychotic therapy and multiple antipsychotic combination therapy on QTc interval were also different.The prolongation of QTc interval caused by antipsychotics is also affected by genetic factors.With the development of pharmacogenetics,many genes related to the prolongation of QTc interval caused by antipsychotics have been identified.This paper reviews the research progress on the influencing factors of QTc interval prolongation caused by antipsychotics,in order to provide reference for clinical diagnosis and treatment.