常用抗精神病药物对精神分裂症患者心电图和心肌酶的影响

The effects of antipsychotic on ECG and myocardial enzyme in patients with schizophrenia

目的探讨精神分裂症常用药物对患者心电图和心肌酶的影响。方法选择2019年1月~2022年6月120例精神分裂症患者为观察对象,根据不同抗精神病药物进行分组,即利培酮组(n=42)、喹硫平组(n=35)、氯氮平组(n=43),治疗疗程均为6个月。比较治疗前后乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)水平,记录治疗期间心电图异常发生情况。结果治疗前三组血清LDH、CK-MB、CK水平差异均无统计学意义(P>0.05),治疗后三组均显著高于治疗前,(P<0.05),但治疗后三组差异无统计学意义(P>0.05);氯氮平组ST-T改变、心动过速发生率显著高于利培酮组与喹硫平组,(P<0.05),三组心动过缓、窦房传导阻滞、窦性心律不齐、QT间期延长发生率差异无统计学意义(P>0.05)。结论利培酮、喹硫平、氯氮平治疗精神分裂症均会产生一定的心脏毒性,引起心电图异常,但氯氮平可造成更多的ST-T改变、心动过速发生。

Objective To investigate the effects of antipsychotic on electrocardiograms(ECG)and myocardial enzyme in patients with schizophrenia.Methods One hundred and twenty patients with schizophrenia from January 2019 to June 2022 were selected as observation subjects.They were grouped according to different antipsychotic drugs:risperidone group(n=42),quetiapine group(n=35),and clozapine group(n=43),and the treatment course was 6 months in all cases.The levels of lactate dehydrogenase(LDH),creatine kinase isoenzyme(CK-MB),and creatine kinase(CK)were compared before and after treatment.The occurrence of electrocardiographic abnormalities during the treatment period was recorded.Results The differences in serum LDH,CK-MB and CK levels were not statistically significant in all three groups before treatment(P>0.05).After treatment,all three groups were significantly higher than before treatment(P<0.05).However,there was no statistically significant difference between the three groups after treatment(P>0.05).The incidence of ST-T changes and tachycardia was significantly higher in the clozapine group than in the risperidone and quetiapine groups(P<0.05).There was no statistically significant difference in the incidence of bradycardia,sinus conduction block,sinus arrhythmia,and QT interval prolongation among the three groups(P>0.05).Conclusion Risperidone,quetiapine,and clozapine for schizophrenia all have some cardiotoxicity and cause ECG abnormalities,but clozapine can cause more ST-T changes and tachycardia to occur.