帕利哌酮用药时间及用药剂量对精神分裂症患者心电图异常特征的影响  

Effect of medication time and dosage of paliperidone on abnormal characteristics of electrocardiogram in schizophrenic patients

作　　者：陈勤 刘昊 孙星 刘晓峥 CHEN Qin;LIU Hao;SUN Xing;LIU Xiaozheng(Department of Psychiatry,Chongqing Municipal Mental Hospital,Chongqing 400038,China;Department of Cardiology,Chongqing Municipal Thirteenth People ′ s Hospital,Chongqing 400053,China)

机构地区：[1]重庆市精神病院精神科,400038 [2]重庆市第十三人民医院心内科,400053

出　　处：《现代医药卫生》2018年第6期836-838,共3页Journal of Modern Medicine & Health

摘　　要：目的探讨帕利哌酮用药时间、用药剂量对中青年男性精神分裂症患者心电图异常特征的影响。方法选择2014年8月至2016年12月重庆市精神病院精神科收治的中青年男性精神分裂症患者62例。根据纳入标准,最终共58例纳入该研究,根据服用帕利哌酮剂量不同将其分为低剂量组(≤6 mg/d)30例和高剂量组(>6 mg/d)28例,2组分别在治疗后4、8、12周进行心电图检测,对比分析2组观察结果。结果 (1)与治疗前比较,高、低剂量组患者均有心电图异常特征发生,在同一用药时间点,2组患者的心电图异常特征发生率比较,差异均无统计学意义(F=0.132、0.180、0.327,P>0.05)。(2)随着时间的增加,治疗后患者的窦性心动过速、窦性心动过缓、窦性心律不齐、S-T段改变及其他异常特征发生率逐渐降低,差异均有统计学意义(F=31.150、11.261、4.119、10.081、9.511,P<0.05),高、低剂量组患者均未出现Q-T间期延长和传导阻滞。(3)随着用药时间的增加,高低剂量组患者的心电图异常特征发生率均逐渐降低,且差异均有统计学意义(χ~2=7.806、14.516、28.452,P<0.01)。结论对于精神分裂症患者,帕利哌酮对心脏的影响较小,且用药剂量对患者的心电图异常发生率无显著影响。帕利哌酮用药时间延长后虽会降低心电图异常发生率,但长期服用药物后仍具有潜在危险,临床医生应定期对精神分裂症患者复查心电图。Objective To investigate the effects of medication time and dosage of paliperidone on electrocardiogram(ECG)abnormality characteristics in young and middle-aged male patients with schizophrenia.Methods Sixty-two young and middle-aged male schizophrenia patients in the department of psychiatry,Chongqing Municipal Mental Hospital from August.2014to Dec.2016were selected and58cases were finally included in the study according to the inclusion standard.The cases were divided into the low dose group(≤6mg/d,30cases)and high dose group(>6mg/d,28cases).The two groups conducted the ECG examination at4,812weeks of treatment.Then the observation results were compared between the two groups.Results(1)Compared with before treatment,both high and low doses of patients have abnormal ECG characteristics,in the same drug time point,the two groups of patients with abnormal ECG characteristics of the incidence of differences are not statistically significant(F=0.132,0.180,0.327,P>0.05).(2)Along with the time increase,the incidence rates of ECG characteristics of sinus bradycardia,sinus tachycardia,sinus irregularity,S-T segment change and other abnormalities were gradually decreased,the difference was statistically significant(F=31.150,11.261,4.119,10.081,9.511,P<0.05).The both groups of high dose and low dose all did not appear Q-T internal prolongation and conduction block.(3)With the increase of medication time,the incidence rate of ECG abnormal characteristics in the two groups were decreased gradually,moreover the difference was statistically significant(χ2=7.806,14.516,28.452,P<0.01).Conclusion In the patients with schizophrenia,paliperidone has little effect of on the heart,moreover the medication dose has no obvious effect on ECG abnormality occurrence rate.After prolonging the paliperidone use time,although the occurrence rate of ECG abnormality could be decreased,but long term medication still has potential risk,so clinical doctor should regularly re-examine ECG on schizophrenia patients.

关 键 词：抗精神病药/治疗应用 帕利哌酮 用药剂量 用药时间 精神分裂症 心电描记术 

分 类 号：R749.3[医药卫生—神经病学与精神病学]