抗精神病药物与精神分裂症患者发生心血管疾病的风险之间的关联:一项嵌套病例控制研究
Peng Peng1,2, Jiqing Li3, Yujiao Chen4
1Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China.
BMJ mental health
|June 8, 2023
概括
抗精神病使用增加了心血管疾病 (CVD) 的风险在中国精神分裂症患者. 风险因药物的类型和剂量而异,需要仔细的临床考虑.
科学领域:
- 药物监督 药物监督 药物监督
- 精神病学是一个精神病学.
- 心脏病学 心脏病学
背景情况:
- 抗精神病药物与心血管疾病 (CVD) 之间的联系是显著的,但尚未完全确立,特别是在中国人群中.
- 精神分裂症患者通常需要抗精神病治疗,强调需要了解相关的心血管风险.
研究的目的:
- 研究抗精神病药物使用与在被诊断为精神分裂症的中国人中患心血管疾病的风险之间的关联.
- 探索不同抗精神病药物之间潜在的剂量反应关系和风险差异.
主要方法:
- 在中国山东进行了一项嵌套病例控制研究,涉及精神分裂症患者.
- 病例被定义为2012年至2020年间发生的CVD诊断,与最多三组对照匹配.
- 使用加权后勤回归和受限立方线分析来评估风险和剂量反应关系.
主要成果:
- 这项研究包括2493例病例和7478例对照. 任何抗精神病药物的使用都与心血管疾病风险增加1.54倍有关.
- 缺血性心脏病的风险更高 (OR=2.26),主要是由于特定的抗精神病药物,如哈洛佩里多尔,阿里皮普拉和奎蒂亚平.
- 观察到一种非线性剂量反应关系,较低剂量的风险急剧增加,较高剂量的风险停滞.
结论:
- 抗精神病药物与精神分裂症患者发生心血管疾病的风险增加有关.
- 心血管风险概况在各种抗精神病药物和特定心血管疾病中存在显著差异.
- 临床医生必须权衡抗精神病药物的心血管风险,并为精神分裂症管理选择适当的药物类型和剂量.
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