氯氮平治疗相关心电图校正QT间期延长及其危险因素  

Electrocardiographic corrected QT interval prolongation and its risk factors in patients with clozapine treatment

作　　者：吕建宝[1] 张向阳 李娟[3] 杨甫德[4] 

机构地区：[1]北京回龙观医院临床一科 北京,100096 [2]Baylor College of Medicine [3]北京回龙观医院医务科 [4]北京回龙观医院

出　　处：《中国神经精神疾病杂志》2014年第7期419-423,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：北京市科技计划项目(编号:D121100005012005)

摘　　要：目的调查精神分裂症患者在氯氮平治疗期间心电图校正QT间期(corrected QT interval,QTc)的变化及其相关因素。方法收集使用氯氮平治疗的210例精神分裂症患者,检测心肌酶等生化指标,检查心电图,按Bazett’s公式计算QTc间期,并以桡动脉搏动次数作为心率。结果 QTc间期延长发生率15.24%,女性QTc间期延长发生率高于男性(29.23%vs.8.98%),差异有统计学意义(P<0.001)。女性QTc间期比男性长([427.30±24.33)ms vs(.410.39±25.80)ms],差异有统计学意义(P<0.001)。QTc间期与年龄(r=0.203,P=0.003)、心率(r=0.326,P<0.001)呈正相关,与氯氮平剂量、治疗时间无统计学相关(均P>0.05)。多因素线性回归分析示,心率与QTc间期有关联(β=0.719,标准化β=0.691,P=0.027)。结论精神分裂症患者在氯氮平治疗期间QTc间期延长发生率高,心率快可能是其危险因素。Objective To investigate risk factors of corrected QT （QTc） interval prolongation in schizophrenia pa-tients treated with clozapine. Methods Two hundred and ten schizophrenia patients treated with clozapine were included in the study. Measurement of myocardial enzymes and electrocardiography were performed to determine QTc interval. QTc interval was calculated according to Bazett’s formula. Results QTc prolongation prevalence rate was 15.24%, The QTc prolongation prevalence rate was higher in female than in male （29.23%vs. 8.98%, P〈0.001）. The mean QTc inter-val was longer in female than in male [（427.30 ± 24.33）ms vs. （410.39 ± 25.80）ms, P〈0.001]. The QTc interval showed weak positive correlation with age （r=0.203, P=0.003） and heart rate （r=0.326, P〈0.001）. There was no correlation be-tween QTc interval and clozapine dosage or therapy course （P〉0.05）. Multi-factors linear regression analysis showed that heart rate was related with QTc interval （β=0.719, standardizedβ=0.691, P=0.027）. Conclusions QTc interval prolonga-tion prevalence rate is high in patients treated with clozapine. And increased heart rate might be risk factor of QTc inter-val prolongation.

关 键 词：精神分裂症 氯氮平 QTC间期延长 

分 类 号：R749.3[医药卫生—神经病学与精神病学]