阿立哌唑、奥氮平及利培酮对首发精神分裂症患者心率变异性的影响  

Effects of Aripiprazole,Olanzapine and Risperidone on Heart Rate Variability in Patients with First-Episode Schizophrenia

作　　者：孙茜[1] 邹琳 万爱兰[1] SUN Qian;ZOU Lin;WAN Ai-lan(Department of Psychosomatics,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Electrocardiogram,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院心身医学科,南昌330006 [2]南昌大学第一附属医院心电图室,南昌330006

出　　处：《南昌大学学报（医学版）》2022年第3期34-37,共4页Journal of Nanchang University：Medical Sciences

基　　金：江西省卫生计生委科技计划项目(20195091)。

摘　　要：目的比较非典型抗精神药阿立哌唑、奥氮平及利培酮对首发精神分裂症患者心率变异性(HRV)的影响。方法将90例首发精神分裂症患者(治疗组)随机分为3个亚组:A组30例给予阿立哌唑治疗,B组30例给予奥氮平治疗,C组30例给予利培酮治疗;同时选取心身健康体检者90例为对照组。比较治疗组与对照组HRV相关指标[包括全部窦性RR间期的标准差(SDNN)、每5 min窦性RR间期均值标准差(SDANN)、每5 min阶段RR间期平均值标准差(SDNNI)、全程相邻RR间期差值的均方根(rMSSD)、全部相邻的RR间期差值大于50 ms的心搏数占检测心搏数的百分数(pNN50)]的差异;观察治疗组3个亚组治疗前后HRV参数的变化。结果与对照组比较,治疗组SDNN、rMSSD、pNN50值显著下降(P<0.05)。与治疗前比较,A组SDNN值显著上升(P<0.05),B组SDNN、SDNNI、pNN50值显著下降(P<0.05),C组rMSSD、pNN50值显著下降(P<0.05)。结论首发精神分裂症患者存在自主神经功能障碍,可导致HRV相关指标值降低;使用非典型抗精神病药物治疗后,奥氮平及利培酮加重HRV指标值降低,可加重患者出现心血管意外风险,阿立哌唑有更好的心脏保护作用。Objective To evaluate the effects of atypical antipsychotic drugs aripiprazole,olanzapine and risperidone on heart rate variability(HRV)in patients with first-episode schizophrenia.Methods A total of 90 patients with first-onset schizophrenia(treatment group)were randomly given aripiprazole(group A,30 cases),olanzapine(group B,30 cases)or risperidone(group C,30 cases).Meanwhile,90 persons undergoing healthy physical examination were enrolled as the control group.HRV-related parameters were compared between treatment group and control group,including standard deviation of all normal sinus RR intervals(SDNN),standard deviation of all mean 5-minute RR intervals(SDANN),mean of the 5-min standard deviations of R-R intervals(SDNNI),root mean squared successive difference(RMSSD),and percentage of successive normal sinus RR intervals>50 ms(pNN50).In addition,the changes in HRV parameters before and after treatment were observed in the three subgroups.Results Compared with the control group,SDNN,RMSSD and pNN50 were decreased in the treatment group(P<0.05).After treatment,SDNN was increased in group A,SDNN,SDNNI and pNN50 were decreased in group B,and rMSSD and pNN50 were reduced in group C(P<0.05).Conclusion Patients with first-episode schizophrenia have autonomic nervous dysfunction,which can lead to a decrease in HRV-related indicators.Both olanzapine and risperidone aggravate the reduction of HRV indexes,which may increase the risk of cardiovascular accidents.Aripiprazole has a cardiac protective effect.

关 键 词：精神分裂症 心率变异性 非典型抗精神病药物 

分 类 号：R749.3[医药卫生—神经病学与精神病学]