精神分裂症患者长期抗精神病药物治疗心电图ST-T改变的危险因素  

Risk factors of ST-T changes of electrocardiogram in patients with schizophrenia during long-term antipsychotics treatment

作　　者：姚桂花 谢勇 易双 Yao Guihua;Xie Yong;Yi Shuang(Electrocardiography Room,Xinyu Beihu Hospital,Xinyu City,Jiangxi Province,338000,China)

机构地区：[1]新余北湖医院心电图室,江西省新余市338000

出　　处：《现代电生理学杂志》2022年第1期25-29,共5页Journal of Modern Electrophysiology

基　　金：新余市科技计划项目(20213090970)。

摘　　要：目的:分析精神分裂症患者长期抗精神病药物治疗心电图ST-T改变的危险因素。方法:收集新余北湖医院2018年3月至2020年3月接受24个月抗精神病药物治疗的93例精神分裂症患者临床资料进行回顾性分析。对所有患者实施心电图检查,将发生心电图ST-T段改变者纳入发生组,未发生者纳入未发生组。采用Logistic多因素回归分析精神分裂症患者长期抗精神病药物治疗期间心电图ST-T改变的危险因素,采用受试者操作特征(ROC)曲线分析血小板计数(PLT)、C反应蛋白(CRP)对心电图ST-T改变的预测价值。结果:93例精神分裂症患者治疗期间共出现43例心电图ST-T改变,其中治疗3、6、12、18、24个月分别出现2、3、6、10、22例。发生组合并基础疾病、吸烟史、饮酒史、合并低钾血症患者比例及PLT、CRP水平明显高于未发生组(P<0.05)。Logistic多因素回归分析显示合并基础疾病、吸烟史、饮酒史、合并低钾血症、PLT、CRP是影响精神分裂症患者长期抗精神病药物治疗期间心电图ST-T改变的独立危险因素(P<0.05)。PLT、CRP预测长期抗精神病药物治疗期间心电图ST-T改变的曲线下面积分别为0.761、0.836,最佳截断值分别为261.355×10^(9)/L、5.120 mg/ml。结论:当合并基础疾病、吸烟史、饮酒史、合并低钾血症、PLT>261.355×10^(9)/L、CRP>5.120 mg/ml时,精神分裂症患者长期抗精神病药物治疗心电图ST-T改变的风险较高。Objective:To analyze the risk factors of ST-T changes of electrocardiogram in patients with schizophrenia during long-term antipsychotics treatment.Methods:The clinical data of 93 patients with schizophrenia who received antipsychotic drugs for 24 months from March 2018 to March 2020 in Xinyu Beihu Hospital were collected and analyzed retrospectively.Electrocardiography was performed in all patients,and those with ST-T changes of electrocardiogram were enrolled in the occurrence group,while those without ST-T changes were enrolled in the non-occurrence group.Logistic multivariate regression was used to analyze the independent risk factors of ST-T changes in patients with schizophrenia during long-term antipsychotics treatment,and the predictive value of platelet count(PLT)and C reactive protein(CRP)on ST-T changes was analyzed by receiver operating characteristic(ROC)curve.Results:There were 43 cases with ST-T changes in 93 patients with schizophrenic during treatment,including 2,3,6,10 and 22 cases after 3,6,12,18 and 24 months of treatment.The proportion of patients with basic diseases,smoking history,drinking history,hypokalemia and the levels of PLT and CRP in the occurrence group were significantly higher than those in the non-occurrence group(P<0.05).Logistic multivariate regression analysis showed that basic diseases,smoking history,drinking history,hypokalemia,PLT and CRP were independent risk factors affecting ST-T changes in patients with schizophrenia during long-term antipsychotics treatment(P<0.05).The area under the curve of PLT and CRP predicting ST-T changes during long-term antipsychotics treatment were 0.761 and 0.836 respectively,and the best cut-off values were 261.355×10^(9)/L and 5.120 mg/ml respectively.Conclusion:The risk of ST-T changes in patients with schizophrenia during long-term antipsychotics treatment is higher when they are combined with basic diseases,smoking history,drinking history,hypokalemia,PLT>261.355×10^(9)/L and CRP>5.120 mg/ml.

关 键 词：精神分裂症 心电描记术 危险因素 抗精神分裂症药物 

分 类 号：R749.3[医药卫生—神经病学与精神病学]