非典型抗精神病药氨磺必利的血药浓度与精神分裂症患者心率变异性的关联性分析

Analysis of the correlation between the blood concentration of atypical antipsychotic amisulpride and heart rate variability in patients with schizophrenia

目的 分析非典型抗精神病药氨磺必利的血药浓度与精神分裂症患者心率及心率变异性(HRV)的关联性。方法 选择2020年1月—2021年3月本院收治住院的精神分裂症患者100例为研究对象,采用随机数表法分为观察组和对照组两组,每组各50例。观察组给予氨磺必利进行治疗,对照组给予利培酮进行治疗。采集患者服药2周、4周后血样,记录血药浓度,并收集服药前、服药2周及4周后的心率及HRV数据。结果 观察组服药2周与服药4周后血药浓度比较,差异有统计学意义(P<0.001);对照组服药2周后与服药4周后血药浓度比较,差异无统计学意义(P>0.05)。服药前、服药2周后两组心率比较,差异均无统计学意义(P>0.05);服药4周后观察组的心率高于对照组,差异具有统计学意义(P>0.05)。服药前,两组HRV各指标比较,差异均无统计学意义(P>0.05);服药2周后、服药4周后观察组HRV各指标均低于对照组,差异具有统计学意义(P<0.05)。观察组服药4周后,HRV各项指标均低于服药2周后,差异具有统计学意义(P<0.05)。结论 随着氨磺必利治疗时间的延长,机体血药浓度会明显上升,导致HRV降低,可能影响心脏自主神经功能,引发一系列心血管不良反应。临床中应加以重视,严格控制血药浓度,或者联合其他药物治疗以避免不良反应的发生。

Objective To analyze the association between blood concentration of atypical antipsychotic amisulpride and heart rate and heart rate variability(HRV) in patients with schizophrenia.Methods A total of 100 schizophrenic inpatients in our hospital from January 2020 to March 2021 were selected as study objects, and they were randomly divided into observation group and control group according to random number table method, 50 cases in each. The observation group was treated with amisulpride, while the control group was treated with risperidone. Blood samples were collected at 2 and 4 weeks after taking the drug, and the blood concentration value was recorded. HR and HRV data were collected at before treatment, 2 weeks after and 4 weeks after taking the drug.Results There were statistically significant difference in blood drug concentration between 2 weeks and 4 weeks after medication in the observation group(P<0.001). However, there were no significant difference in blood drug concentration between 2 weeks and 4 weeks after medication in the control group(P>0.05). There was no significant difference in heart rate between the two groups before and 2 weeks after administration(P>0.05).The heart rate of the observation group was higher than that of the control group after 4 weeks of medication, the difference was statistically significant(P<0.05). Before medication, there was no significant difference in HRV indexes between the two groups(P>0.05).All HRV indexes in the observation group were lower than those in the control group after 2 weeks of medication and 4 weeks of medication, and the differences were statistically significant(P<0.05). All HRV indexes in the observation group after 4 weeks were lower than those after 2 weeks, the difference was statistically significant(P<0.05).Conclusions With the extension of treatment time of amisulpride, blood drug concentration in the body will increase significantly, leading to the decrease of HRV, which may affect the function of cardiac autonomic nerve and cause a series of cardiovascular adverse reactions. Clinical attention should be paid to the strict control of blood drug concentration, or through the combination of other drug therapy to avoid the occurrence of adverse reactions.