抗精神病药物的心血管副作用及其机制的研究进展  

Research progress of cardiovascular side effects and potential mechanisms of antipsychotic drugs

作　　者：吴艳琴[1] 党瑞丽[1] 江沛[1] 李焕德[1,2] 唐密密[1] 蔡骅琳[1,2] 

机构地区：[1]中南大学湘雅二医院临床药学研究室,长沙410011 [2]中南大学湘雅二医院药学部,湖南长沙410011

出　　处：《中国医院药学杂志》2016年第4期327-331,共5页Chinese Journal of Hospital Pharmacy

基　　金：国家自然科学基金青年基金项目(编号:81401113)

摘　　要：近年来,心血管疾病已成为精神障碍患者的主要死因,这引起了国内外学者的广泛关注。多数非典型抗精神病药都会导致显著的代谢不良反应,继而引发心血管疾病。随着抗精神药物的适应证和适应人群的不断扩大,抗精神病药物导致的心血管疾病的机制研究迫在眉睫。越来越多的研究表明,抗精神病药对外周及中枢神经的非特异性的药理作用导致了其心血管副作用,如体位性低血压、心动过速和室性心律失常等,其心血管副作用可能与肾上腺素能受体或胆碱能受体和hERG钾通道的阻断有关,也有可能与自主神经功能受损有关。本次综述旨在结合临床前和临床研究成果,分析并讨论抗精神病药物对心血管系统的直接或间接的影响以及不良反应发生的机制,进而全面了解抗精神病药物对心血管系统的副作用。Cardiovascular diseases have been the major causes of death in patients with mental disorders in recent years. The majority of atypical antipsychotic drugs have significant metabolic side effects, which subsequently cause cardiovascular diseases. Through these years, use of antipsyehotic drugs continues to expand into new indications and populations such as children and adolescents, but mechanisms of these antipsychotic-induced cardiovascular abnormalities have not been fully expounded. Studies show that the non-specific pharmacological actions of atypical antipsychotic drugs to central and peripheral nervous sys- tem may be responsible for its cardiovascular side effects, such as orthostatic hypotension, tachycardia and ventrieular arrhyth- mias. It may also relate to blockade of adrenergic or cholinergic receptors and hERG channels, in addition to impaired autonom- ic function. In this review, we integrate both preclinical and clinical findings, aiming to discuss and analyze direct and indirect effects of antipsychotic drugs on cardiovascular system and their possible mechanisms of action.

关 键 词：抗精神病药物 心血管 自主神经 代谢 

分 类 号：R971.4[医药卫生—药品]