在现实世界中,第二代抗精神病药物诱导的QTc延长的比较风险:基于医院信息系统的回顾性队列研究
Luyao He1,2, Wenjuan Yu1,2, Huiqing Song3
1Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
BJPsych open
|March 10, 2025
概括
第二代抗精神病药物 (SGA),如齐普拉西,阿米苏普利德和奥兰扎宾,增加了纠正的QT间隔 (QTc) 延长的风险. 建议定期对服用这些药物的患者进行心电图监测.
科学领域:
- 精神病学是一个精神病学.
- 心脏病学 心脏病学
- 药理学 药理学 是一个学科.
背景情况:
- 第二代抗精神病药物 (SGA) 通常用于各种精神疾病.
- 一些SGA的已知副作用是纠正的QT间隔 (QTc) 延长,这引发了安全问题.
- 了解与不同SGA相关的特定风险对于患者安全至关重要.
研究的目的:
- 评估八种不同的SGA的QTc延长风险.
- 分析QTc延长事件的时间模式.
- 检查QTc延长后后续的药物管理策略.
主要方法:
- 以回顾性队列研究,使用2007-2019年医院信息系统数据.
- 包括5130名患者,随访时间中位数为141.2天.
- 应用边际结构考克斯模型来比较SGA中QTc延长的危险比率.
主要成果:
- 齐普拉西,阿米苏普利德和奥兰扎被确定为与QTc延长相关的SGA.
- 齐普拉西显示的风险最高 (HR 1.72,P=0.03),其次是阿米苏普里德 (HR 1.56,P=0.03) 和奥兰扎平 (HR 1.40,P=0.04).
- 研究队列包括5130名患者,平均年龄为35.54岁,47.8%是男性.
结论:
- 齐普拉西,阿米苏普利德和奥兰扎宾携带高QTc延长的风险.
- 临床医生应该考虑定期的心电图 (ECG) 监测,在处方这些特定的SGA.
- 这一发现有助于优化精神病治疗中的患者安全和药物管理.
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