第二代抗精神病药物对精神分裂症患者心功能的影响  

Effect of second-generation antipsychotics on cardiac function in patients with schizophrenia

作　　者：陶云海[1] 施剑飞[1] 江长旺[1] 申变红[1] 朱春燕[1] 

机构地区：[1]浙江省杭州市第七人民医院一病区精神科,浙江310013

出　　处：《实用药物与临床》2014年第9期1127-1130,共4页Practical Pharmacy and Clinical Remedies

基　　金：2011年浙江省医药卫生科技项目(2011KYA135)

摘　　要：目的分析第二代抗精神病药物对精神分裂症患者心功能的影响及其不良反应。方法选取我院2011年1月至2013年12月诊治的精神分裂症患者100例,随机分为5组,分别为利培酮组20例,喹硫平组20例,奥氮平组20例,阿立哌唑组20例,齐拉西酮组20例。所有精神分裂症患者用药前及用药后1、2、3周均采用运动平板试验进行评估,治疗后的第1、2、3周分别进行B超、肝肾功能、血常规、血脂、血糖、水电解质、血清催乳素检查,并观察不良反应发生情况。结果喹硫平、奥氮平组患者体重增加及血糖升高例数多于其他组,喹硫平组患者心动过速例数多于其他组,利培酮组、喹硫平组、奥氮平组过度镇静例数多于其他组,差异均有统计学意义(P<0.05)。利培酮组(55%)、喹硫平组(65%)、奥氮平组(85%)不良反应发生率显著高于阿立哌唑组(30%)和齐拉西酮组(40%),差异有统计学意义(P<0.05)。五组患者用药3周后,运动平板试验阳性数、自我疲劳等级较用药前显著增高,达亚极量心率所需时间较用药前显著缩短,差异有统计学意义(P<0.05)。五组药物对精神分裂症患者心功能均有不同程度的影响,五组引起各种心血管不良反应发生率比较差异无统计学意义(P>0.05)。结论第二代抗精神病药物可以引起精神分裂症患者的心功能改变,齐拉西酮引起的QTc间期延长较突出,喹硫平可引发室上性心动过速、体位性低血压、心律失常等,利培酮、喹硫平、奥氮平引起不良反应较多,临床上应加以注意。Objective To analyze the impact of the second generation antipsychotics on cardiac function of patients with schizophrenia and its adverse reactions.Methods 100 cases of schizophrenia patients in our hospital from January 2011 to December 2013 were randomly divided into five groups：risperidone group,quetiapine group,olanzapine group,aripiprazole azole group,ziprasidone group,20 cases in each group.All patients were evaluated by exercise treadmill test before the treatment and at one week,two weeks,three weeks after treatment.The ultrasound B,liver and kidney function,blood lipids,blood glucose,water and electrolytes,serum prolactin and the adverse reactions after treated for one week,two weeks,three weeks were observed and recorded.Results The number of patients with increased body weight,blood glucose in quetiapine group and olanzapine group were higher than those of the other groups,the number of patients with tachycardia in quetiapine group was more than those of the other groups,the number of excessive sedation of risperidone group,quetiapine group,olanzapine group were more than those of the other groups （P ＜0.05）.The incidence of adverse reactions of risperidone group（55％）,quetiapine group（65％） and olanzapine group （85 ％） were significantly higher than those of aripiprazole group （30％） and ziprasidone group （40 ％） （P ＜ 0.05）.The number of positive treadmill exercise test,degree of self fatigue rating of the five group were increased after three weeks treatment,the time of submaximal heart rate was significantly reduced（P ＜ 0.05）.5 drugs had different effects on cardiac function in patients with schizophrenia,cardiovascular adverse reactions of each group had no statistical significance（P ＞ 0.05）.Conclusion The second-generation antipsychotics can cause changes in heart tunction in patients with schizophrenia,aiprasidone cause QTc interval prolongation more prominent,quetiapine can cause supraventricular tachycardia,orthostatic hypotension,arrhythmia,re

关 键 词：第二代抗精神病药物 精神分裂症 心功能 不良反应 

分 类 号：R749.3[医药卫生—神经病学与精神病学]