盐酸哌甲酯控释片治疗儿童注意缺陷多动障碍的心血管安全性  

Cardiovascular Safety of Methylphenidate Hydrochloride Controlled-Release Tablets in Children with Attention Deficit Hyperactivity Disorder

作　　者：张婕[1] 王丽芳[1] 赵小艳[1] 高敬文[1] 彭军[1] Zhang Jie;Wang Lifang;Zhao Xiaoyan;Gao Jingwen;Peng Jun(Xi'an Children's Hospital,Shaanxi Xi'an 710002,China)

机构地区：[1]西安市儿童医院,陕西西安710002

出　　处：《儿科药学杂志》2020年第8期10-13,共4页Journal of Pediatric Pharmacy

基　　金：陕西省重点研发计划项目,编号2018SF229。

摘　　要：目的:探讨盐酸哌甲酯控释片治疗儿童注意缺陷多动障碍(ADHD)对心血管系统的影响。方法:回顾性分析98例ADHD患儿的临床资料。所有患儿均服用盐酸哌甲酯控释片治疗,初始剂量为18 mg/d,2周后如临床症状缓解不理想调整至36 mg/d。经过SNAP-Ⅳ量表评估有效,家长能够坚持治疗,服药满3个月为1个观察周期。观察治疗前后患儿心血管系统安全性指标的变化情况。结果:与治疗前比较患儿治疗后心率加快(P<0.05),收缩压、舒张压无明显变化(P>0.05);心率变异性和心力减速力降低(P<0.05),但均处于正常范围。不同用药剂量人群的总体不良反应发生率及心血管指标比较差异无统计学意义(P>0.05)。结论:盐酸哌甲酯控释片治疗儿童ADHD对心血管系统的影响较小,但长期用药的影响还有待进一步研究证实。Objective: To probe into the effects of methylphenidate hydrochloride controlled-release tablets on the cardiovascular system of children with attention deficit hyperactivity disorder( ADHD). Methods: Retrospective analysis was performed on clinical data of 98 children with ADHD. All children were treated with methylphenidate hydrochloride controlled-release tablets at an initial dose of 18 mg/d,which was adjusted to 36 mg/d after 2 weeks,if the clinical relief was unsatisfactory. After being evaluated by the SNAP-Ⅳ scale,parents were able to adhere to the treatment,and one observation period of 3 months of medication was used. Changes of safety indexes of cardiovascular system were observed before and after treatment. Results: Compared with before treatment,children’s heart rate increased after treatment( P<0.05),and there was no significant change in systolic blood pressure and diastolic blood pressure( P>0.05);the heart rate variability and heart deceleration decreased after treatment( P<0.05),but both were within the normal range. There was no statistically significant difference in the incidence of adverse drug reactions and cardiovascular indexes among people with different medication doses( P>0.05). Conclusion: Treatment of methylphenidate hydrochloride controlled-release tablets for children with ADHD has less effects on the cardiovascular system,yet the effect of long-term administration needs to be confirmed by further studies.

关 键 词：盐酸哌甲酯控释片 注意缺陷多动障碍 心血管系统 

分 类 号：R748[医药卫生—神经病学与精神病学]