单硝酸异山梨酯片治疗抗精神病药致QTc间期延长疗效观察
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摘要
目的探讨单硝酸异山梨酯片对第二代抗精神病药物所致QTc间期延长的疗效。方法选取临沂市荣军医院2015年5月至2018年8月收住院,服用第二代抗精神病药物治疗期间ECG检查QTc延长>10ms精神分裂症患者47例。患者确诊后随机分为治疗组(24例,口服单硝酸异山梨酯)和对照组(23例,口服复方丹参滴丸),在继续原抗精神病药物治疗基础上分别口服单硝酸异山梨酯片10mg,每日2次;复方丹参滴丸10丸,每日3次,连续治疗4周后予12导联心电图检查,观察患者心电图变化情况。结果两组治疗后,QTc间期与治疗前比较差异有统计学意义(P<0.01);两组间比较差异无统计学意义(P>0.05)。结论单硝酸异山梨酯片治疗第二代抗精神病药物所致QTc间期延长疗效满意,可降低严重心律失常的发生率。
Objective To study the effect of Isosorbide Mononitrate Tablets on QTc interval prolongation caused by second generation antipsychotics drugs.Methods 47 patients with schizophrenia whose QTc was longer than 10 ms were selected from Linyi Rongjun Hospital from May 2015 to August 2018.The patients were randomly divided into treatment group(24 cases,taking Isosorbide Mononitrate orally)and control group(23 cases,taking Compound Danshen Dropping Pills orally).After 4 weeks of continuous treatment,the ECGQTcchanges of the two groups were compared.Results After treatment,QTc interval between the two groups was significantly different from that before treatment(P<0.01).There was no significant difference between the two groups(P>0.05).Conclusion Isosorbide mononitrate are effective in treating QTC interval prolongation caused by second generation antipsychotics and can reduce the incidence of serious arrhythmia.
Objective To study the effect of Isosorbide Mononitrate Tablets on QTc interval prolongation caused by second generation antipsychotics drugs.Methods 47 patients with schizophrenia whose QTc was longer than 10 ms were selected from Linyi Rongjun Hospital from May 2015 to August 2018.The patients were randomly divided into treatment group(24 cases,taking Isosorbide Mononitrate orally)and control group(23 cases,taking Compound Danshen Dropping Pills orally).After 4 weeks of continuous treatment,the ECGQTcchanges of the two groups were compared.Results After treatment,QTc interval between the two groups was significantly different from that before treatment(P<0.01).There was no significant difference between the two groups(P>0.05).Conclusion Isosorbide mononitrate are effective in treating QTC interval prolongation caused by second generation antipsychotics and can reduce the incidence of serious arrhythmia.
引文
1 谈艳,张少平,陈银娣.抗抑郁药和抗精神病药物所致QT间期延长和尖端扭转型室速[J].中国神经精神疾病杂志,2004,30(5):附3-附5.
2 Khalaf MAM,AbdelRahman TM,Abbas MF.Values of using QTc and N-terminal fragment of B-type natriuretic peptide as markers for early detection of acute antipsychotic drugs-induced cardiotoxicity[J].Cardiovasc Toxicol,2011,11(1):10-17.
3 Lammers L,Zehm B,williams R.Risperidone long-acting injection in Schizophrenia Spectrum Illnesses compared to firstgeneration depot antipsychotics in an outpatient setting in Canada[J].BMC Psychiatry,2013,13(1):155.
4 杨小波,袁祖贻,赵朝,等.4种非典型抗精神病药对精神分裂症患者心电图校正QT的影响[J].中国神经精神疾病杂志,2012,38(9):544-547.
5 周双桨,张立刚,魏立和,等.第二代抗精神病药治疗首发精神分裂症患者QTc间期变化的相关因素分析[J].国际精神病学杂志,2016,43(5):788-790,793.
6 陈智敏,温乃义,侯成业.3种抗精神病药对精神分裂症患者心电图QT间期影响[J].临床精神医学杂志,2015,25(6):408-408.
7 Dworkin R H.Pain insensitivity in schizophrenia:a neglected phenomenon and some implications.[J].Schizophrenia Bulletin,1994,20(2):235-248.
8 Kelly RF,Parillo JE,Hollenberg SM.Effect of coronary angioplasty on QT dispersion[J].Am Heart J,1997,134(3):399-405.
9 Sporton S C,Taggart P,Sutton P M,et al.Acute ischaemia:a dynamic influence on QT dispersion.[J].Lancet,1997,349(9048):306.
10 朱毅平,卢胜利,周虎江.复方丹参滴丸治疗抗精神病药所致QTc间期延长临床研究[J].实用中西医结合临床,2004,4(2):3-4.
11 王炳勇,宋彦,何英魁,等.冠心丹参滴丸治疗QTc间期延长的疗效观察[J].中西医结合心血管病电子杂志,2016,4(20):67.
2 Khalaf MAM,AbdelRahman TM,Abbas MF.Values of using QTc and N-terminal fragment of B-type natriuretic peptide as markers for early detection of acute antipsychotic drugs-induced cardiotoxicity[J].Cardiovasc Toxicol,2011,11(1):10-17.
3 Lammers L,Zehm B,williams R.Risperidone long-acting injection in Schizophrenia Spectrum Illnesses compared to firstgeneration depot antipsychotics in an outpatient setting in Canada[J].BMC Psychiatry,2013,13(1):155.
4 杨小波,袁祖贻,赵朝,等.4种非典型抗精神病药对精神分裂症患者心电图校正QT的影响[J].中国神经精神疾病杂志,2012,38(9):544-547.
5 周双桨,张立刚,魏立和,等.第二代抗精神病药治疗首发精神分裂症患者QTc间期变化的相关因素分析[J].国际精神病学杂志,2016,43(5):788-790,793.
6 陈智敏,温乃义,侯成业.3种抗精神病药对精神分裂症患者心电图QT间期影响[J].临床精神医学杂志,2015,25(6):408-408.
7 Dworkin R H.Pain insensitivity in schizophrenia:a neglected phenomenon and some implications.[J].Schizophrenia Bulletin,1994,20(2):235-248.
8 Kelly RF,Parillo JE,Hollenberg SM.Effect of coronary angioplasty on QT dispersion[J].Am Heart J,1997,134(3):399-405.
9 Sporton S C,Taggart P,Sutton P M,et al.Acute ischaemia:a dynamic influence on QT dispersion.[J].Lancet,1997,349(9048):306.
10 朱毅平,卢胜利,周虎江.复方丹参滴丸治疗抗精神病药所致QTc间期延长临床研究[J].实用中西医结合临床,2004,4(2):3-4.
11 王炳勇,宋彦,何英魁,等.冠心丹参滴丸治疗QTc间期延长的疗效观察[J].中西医结合心血管病电子杂志,2016,4(20):67.