奥氮平所致儿童心电图异常的临床分析  

Clinical analysis on abnormal declrocardiograrn induced by olanzapine in children

作　　者：杨超[1] 陈强[1] 张莉[1] 

机构地区：[1]乌鲁木齐市第四人民医院儿童心理科,830002

出　　处：《神经疾病与精神卫生》2017年第7期492-495,共4页Journal of Neuroscience and Mental Health

摘　　要：目的了解奥氮平所致儿童心电图异常的临床特点及转归。方法收集2012年6月至2016年6月在乌鲁木齐第四人民医院儿童心理科住院并初次应用奥氮平治疗患者的病历资料进行回顾性分析，分析心电图异常总发生率、不同奥氮平剂量组、不同用药时间患者心电图异常的发生率和心电图异常的表现、治疗及转归。结果共纳入198例患者，奥氮平所致心电图异常的总发生率为57．07％，低剂量组与高剂量组心电图异常发生率差异具有统计学意义（P〈0．01）。第1、2、3个月心电图异常发生率分别为53．98％、24．78％和21．24％。两组患者用药后第1、3个月的差异有统计学意义（P〈0．05）。合并（二联、三联）用药后，奥氮平高、低剂量组心电图异常发生率的差异无统计学意义（P〉0．05）。奥氮平所致心电图异常主要表现为窦性心动过速、ST—T改变、T波改变和窦性心律不齐等。出现心电图异常的113例患者中，予换药及对症处理后均恢复正常。结论奥氮平所致儿童心电图异常以窦性心律失常、ST—T改变及T波改变较为多见，与用药剂量有关，经适当处理后可完全恢复。Objective To understand the clinical characteristics and outcomes of electrocardiogram （ECG） abnormalities induced by Olanzapine in children. Methods Medical records of patients who had hospitalized in Department of Childhood Psychiatry, Urumqi Fourth People＇ s Hospital and treated with olanzapine for the first time from June 2012 to June 2016 were collected and retrospectively analyzed. The incidence, characteristics, treatments and outcomes of ECG abnormalities were analyzed. Results A total of 198 patients were enrolled into this study. The total incidenee of ECG abnormalities was 57.07% and the difference between the low dose and high dose groups was statistically significant（P 〈 0.01）. The incidences in the 1, 2 and 3 months were 53.98%, 24.78% and 21.24% respectively. There were statistical significance between the low dose and high dose groups in the 1, 3 months （P 〈 0.05）. No statistical significance was found in abnormal ECG between olanzapine high dose and low dose groups after double and triple combinations （P 〉 0.05）. The main characteristics of abnormal ECG induced by Olanzapine were sinus tachycardia, ST-T changes, T wave changes and sinus arrhythmia, etc. The clinical symptoms were completely relieved after dressing change and symptomatic treatment in 133 patients. Conclusions Sinus arrhythmia, ST-T changes and T wave changes are more common in ECG abnormalities caused by Olanzapine. ECG abnormalities are related with the dosage, and could return entirely to normal after proper treatment.

关 键 词：儿童 奥氮平 心电图 

分 类 号：R74[医药卫生—神经病学与精神病学]