阿立哌唑和喹硫平及利培酮对首发精神分裂症患者心电图异常率的影响

Effect of aripiprazole and quetiapine and risperidone on abnormal rate of electrocardiogram in patients with first-episode schizophrenia

目的探讨阿立哌唑、喹硫平、利培酮对首发精神分裂症患者心电图异常率的影响。方法选取2020年5月至2021年5月泰安市精神病医院收治的300例首发精神分裂症患者作为研究对象,按照随机数字表法分为阿立哌唑组、喹硫平组与利培酮组,每组100例。阿立哌唑组采用阿立哌唑治疗,喹硫平组采用喹硫平治疗,利培酮组采用利培酮治疗,比较3组临床疗效、心电图异常率、心肌酶指标[谷草转氨酶(AST)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、乳酸脱氢酶(LDH)及α-羟丁酸脱氢酶(α-HBDH)]。结果3组治疗总有效率比较差异无统计学意义。治疗前及治疗2周,3组心电图异常率比较差异无统计学意义;治疗8、24周,3组心电图异常率比较差异有统计学意义(P<0.05),利培酮组心电图异常率低于阿立哌唑组、喹硫平组,3组心电图异常率均高于治疗前、治疗2周,差异有统计学意义(P<0.05);治疗24周,喹硫平组心电图异常率低于阿立哌唑组,阿立哌唑组电图异常率高于治疗8周,差异有统计学意义(P<0.05)。治疗2、8、24周,3组AST、CK-MB、CK、α-HBDH水平均高于前一时间点,差异有统计学意义(P<0.05);治疗8、24周,3组LDH水平均高于治疗前及前一时间点,差异有统计学意义(P<0.05);其余时间点两两比较差异无统计学意义。治疗8、24周,利培酮组AST、CK-MB、LDH、CK、α-HBDH水平均低于喹硫平组、阿立哌唑组,且喹硫平组低于阿立哌唑组,差异有统计学意义(P<0.05);其余指标组间两两比较差异无统计学意义。结论阿立哌唑、喹硫平、利培酮治疗首发精神分裂症效果相当,且均会对心脏组织造成一定程度损伤,以阿立哌唑对心脏影响最大,临床用药还需谨慎选用。

Objective To investigate the effects of aripiprazole,quetiapine and risperidone on the abnormal rate of electrocardiogram in patients with first-episode schizophrenia.Methods 300 patients with first-episode schizophrenia admitted to Tai'an Psychiatric Hospital of Shandong Province from May 2020 to May 2021 were selected as the research subjects,and they were divided into the aripiprazole group,the quetiapine group and the risperidone group according to the random number table method,with 100 cases in each group.The aripiprazole group was treated with aripiprazole,the quetiapine group was treated with quetiapine,and risperidone group was treated with risperidone,the clinical efficacy,abnormal rate of electrocardiogram and myocardial enzyme indexes(aspartate aminotransferase[AST],creatine kinase isoenzyme[CK-MB],creatine kinase[CK],lactate dehydrogenase[LDH]andα-hydroxybutyrate dehydrogenase[α-HBDH])were compared among the three groups.Results There was no significant difference in the total effective rate among the three groups.Before treatment and 2 weeks after treatment,there was no significant difference in the abnormal rate of electrocardiogram among the three groups;after 8 and 24 weeks of treatment,there were statistically significant differences in the abnormal rate of electrocardiogram among the three groups(P<0.05),the abnormal rate of electrocardiogram in the risperidone group was lower than that in the aripiprazole group and the quetiapine group,and the abnormal rate of electrocardiogram among the three groups was higher than that before treatment and after 2 weeks of treatment,the differences were statistically significant(P<0.05);after 24 weeks of treatment,the abnormal rate of electrocardiogram in the quetiapine group was lower than that in the aripiprazole group,and the abnormal rate of electrogram in aripiprazole group was higher than that after 24 weeks of treatment,the differences were statistically significant(P<0.05).After 2,8 and 24 weeks of treatment,the levels of AST,CK-MB,CK andα-HBDH among the three groups were higher than those at the previous time point,and the differences were statistically significant(P<0.05);at 8 and 24 weeks of treatment,the levels of LDH among the three groups were higher than those before treatment and at the previous time point,and the differences were statistically significant(P<0.05);there was no significant difference between the other time points.After 8 and 24 weeks of treatment,the levels of AST,CK-MB,LDH,CK andα-HBDH in the risperidone group were lower than those in the quetiapine group and the aripiprazole group,and the quetiapine group was lower than the aripiprazole group,the differences were statistically significant(P<0.05);there was no significant difference in the other indexes between the two groups.Conclusion Aripiprazole,quetiapine and risperidone have similar effects in the treatment of first-episode schizophrenia,and all of them will cause a certain degree of damage to the heart tissue,aripiprazole has the greatest impact on the heart,and clinical medication needs to be carefully selected.