精神病患者的QTc间隔异常和精神药物治疗
J G Reilly1, S A Ayis, I N Ferrier
1Academic Department of Psychiatry, University of Newcastle Upon Tyne, UK.
Lancet (London, England)
|April 1, 2000
概括
服用某些抗精神病药物的精神病患者面临更高的QTc延长风险,这是危险心律的标志物. 剂量很重要,更高的剂量增加了药物诱导心律失常的风险.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 精神病患者的突然无法解释的死亡是令人担忧的.
- 药物诱导的心律失常,QT间隔延长表明,是一个潜在的原因.
- 速率校正的QT间隔 (QTc) 是心律失常的预测标志物.
研究的目的:
- 为了估计精神病患者QTc延长的患病率.
- 评估各种精神药物对QTc间隔的影响.
主要方法:
- 分析了495名精神病患者和101名健康对照者的心电图.
- 经过验证的数字化技术用于ECG分析.
- 后勤回归确定了QTc延长和T波异常的预测因素.
主要成果:
- 在8%的精神病患者中发现异常的QTc (>456毫秒).
- 预测QTc延长的预测因素包括65岁以上的年龄,三环抗抑郁药, thioridazine,droperidol和抗精神病剂量.
- 治疗与QT分散和T波异常有关,与抗精神病药物不同.
结论:
- 抗精神病药物会以剂量依赖的方式导致QTc延长.
- 蒂奥里达辛和德罗皮多尔对QTc延长的风险要大得多.
- 这些发现表明,与特定抗精神病药物使用相关的药物诱导心律失常的风险增加.
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