奥氮平和奋乃静对老年精神分裂症患者血压变异的影响
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摘要
目的比较奥氮平和奋乃静对老年精神分裂症患者血压的影响。方法收集2016年2月—2018年6月在我院儿老科住院的60例老年精神分裂症患者,随机分为两组,奥氮平组和奋乃静组,各自给予奥氮平和奋乃静单药治疗;采用24 h动态血压监测技术,收集治疗前后的血压及其变异系数等指标数据。结果奥氮平与奋乃静均可引起老年精神分裂症患者血压的下降,对血压变异性亦有影响,两组药物治疗后舒张压的平滑指数均有下降,差异有统计学意义(P <0.05)。结论抗精神病药物奥氮平和奋乃静对精神分裂症患者的血压稳定性有一定的影响,尤其是对舒张压的影响;提示精神分裂症患者服用抗精神病药物治疗时应关注舒张压的影响。
Objective To compare the effects of olanzapine and perphenazine on blood pressure of elderly schizophrenics. Methods Sixty elderly schizophrenics staying in the department of pediatrics and geriatrics in our hospital form February 2016 to June 2018 were randomly divided into two groups under monotherapy: one took olanzapine and the other took perphenazine, then 24-hour ambulatory blood pressure monitoring was adopted to collect the index data before and after treatment, such as blood pressure, coefficient of variation, etc. Results Both olanzapine and perphenazine could cause the decrease of blood pressure of elderly schizophrenics and influence on the variability of their blood pressure. Their diastolic blood pressure smoothness index felled down after treatment with both drugs. Statistics shew discrepancy of P value of both groups, the difference was significant(P < 0.05). Conclusion Both olanzapine and perphenazine have certain effects on blood pressure stability of schizophrenic patients, especially on diastolic blood pressure,suggesting that attention should be paid to the effects of diastolic blood pressure when schizophrenic patients take antipsychotic drugs.
Objective To compare the effects of olanzapine and perphenazine on blood pressure of elderly schizophrenics. Methods Sixty elderly schizophrenics staying in the department of pediatrics and geriatrics in our hospital form February 2016 to June 2018 were randomly divided into two groups under monotherapy: one took olanzapine and the other took perphenazine, then 24-hour ambulatory blood pressure monitoring was adopted to collect the index data before and after treatment, such as blood pressure, coefficient of variation, etc. Results Both olanzapine and perphenazine could cause the decrease of blood pressure of elderly schizophrenics and influence on the variability of their blood pressure. Their diastolic blood pressure smoothness index felled down after treatment with both drugs. Statistics shew discrepancy of P value of both groups, the difference was significant(P < 0.05). Conclusion Both olanzapine and perphenazine have certain effects on blood pressure stability of schizophrenic patients, especially on diastolic blood pressure,suggesting that attention should be paid to the effects of diastolic blood pressure when schizophrenic patients take antipsychotic drugs.
引文
[1]李凌江.精神分裂症长期药物治疗的依从性[J].中华精神科杂志,2018,51(1):67-68.
[2]Iversen TSJ,Steen NE,Dieset I,et al.Side effect burden of antipsychotic drugs inreallife-Impact of gender and polypharmacy[J].Prog Neuropsychopharmacol Biol Psychiatry,2018,82:263-271.
[3]Pakpoor J,Agius M.A review of the adverse side effects associated with antipsychotics as related to their efficacy[J].Psychiatr Danub,2014,26(Suppl 1):273-284.
[4]王继光,吴兆苏,孙宁玲,等.动态血压监测临床应用中国专家共识[J].中华高血压杂志,2015,23(8):727-730.
[5]Shimada K.[Brief overview of the guidelines for the use of 24hour ambulatory blood pressure monitoring(ABPM)][J].Nihon Rinsho Japanese Journal of Clinical Medicine,2014,72(8):1363-1367.
[6]Iannucci G,Petramala L,La TG,et al.Evaluation of tolerance to ambulatory blood pressure monitoring:Analysis of dipping profile in a large cohort of hypertensive patients[J].Medicine,2017,96(50):e9162.
[7]Stevens SL,Wood S,Koshiaris C,et al.Blood pressure variability and cardiovascular disease:systematic review and meta-analysis[J].BMJ,2016,354:i4098.
[8]Parati G,Omboni S,Rizzoni D,et al.The smoothness index:a new,reproducible and clinically relevant measure of the homogeneity of the blood pressure reduction with treatment for hypertension[J].Journal of Hypertension,1998,16(11):1685-1691.
[9]Amlan Kusum Jana,Samir Kumar Praharaj,Nirmalya Roy.Olanzapine-induced Orthostatic Hypotension[J].Clinical Psychopharmacology&Neuroscience,2015,13(1):113-114.
[10]吴艳琴,党瑞丽,江沛,等.抗精神病药物的心血管副作用及其机制的研究进展[J].中国医院药学杂志,2016,36(4):327-331.
[11]Soysal P,Aydin AE,Koc OS,et al.When should orthostatic blood pressure changes be evaluated in elderly:1st,3rd or 5th minute?[J].Arch Gerontol Geriatr,2016,65:199-203.
[12]Jann MW,Kennedy WK.Safety and Toler ability of Antipsychotics[M].2016:172,273.
[13]Olesen TB,Stidsen JV,Blicher MK,et al.Impact of Age and Target-Organ Damage on Prognostic Value of 24-Hour Ambulatory Blood Pressure[J].Hypertension,2017,70(5):1034-1041.
[14]黄招玲.高龄老年高血压合并体位性低血压患者的临床特点[J].中国卫生标准管理,2017,8(18):34-36.
[2]Iversen TSJ,Steen NE,Dieset I,et al.Side effect burden of antipsychotic drugs inreallife-Impact of gender and polypharmacy[J].Prog Neuropsychopharmacol Biol Psychiatry,2018,82:263-271.
[3]Pakpoor J,Agius M.A review of the adverse side effects associated with antipsychotics as related to their efficacy[J].Psychiatr Danub,2014,26(Suppl 1):273-284.
[4]王继光,吴兆苏,孙宁玲,等.动态血压监测临床应用中国专家共识[J].中华高血压杂志,2015,23(8):727-730.
[5]Shimada K.[Brief overview of the guidelines for the use of 24hour ambulatory blood pressure monitoring(ABPM)][J].Nihon Rinsho Japanese Journal of Clinical Medicine,2014,72(8):1363-1367.
[6]Iannucci G,Petramala L,La TG,et al.Evaluation of tolerance to ambulatory blood pressure monitoring:Analysis of dipping profile in a large cohort of hypertensive patients[J].Medicine,2017,96(50):e9162.
[7]Stevens SL,Wood S,Koshiaris C,et al.Blood pressure variability and cardiovascular disease:systematic review and meta-analysis[J].BMJ,2016,354:i4098.
[8]Parati G,Omboni S,Rizzoni D,et al.The smoothness index:a new,reproducible and clinically relevant measure of the homogeneity of the blood pressure reduction with treatment for hypertension[J].Journal of Hypertension,1998,16(11):1685-1691.
[9]Amlan Kusum Jana,Samir Kumar Praharaj,Nirmalya Roy.Olanzapine-induced Orthostatic Hypotension[J].Clinical Psychopharmacology&Neuroscience,2015,13(1):113-114.
[10]吴艳琴,党瑞丽,江沛,等.抗精神病药物的心血管副作用及其机制的研究进展[J].中国医院药学杂志,2016,36(4):327-331.
[11]Soysal P,Aydin AE,Koc OS,et al.When should orthostatic blood pressure changes be evaluated in elderly:1st,3rd or 5th minute?[J].Arch Gerontol Geriatr,2016,65:199-203.
[12]Jann MW,Kennedy WK.Safety and Toler ability of Antipsychotics[M].2016:172,273.
[13]Olesen TB,Stidsen JV,Blicher MK,et al.Impact of Age and Target-Organ Damage on Prognostic Value of 24-Hour Ambulatory Blood Pressure[J].Hypertension,2017,70(5):1034-1041.
[14]黄招玲.高龄老年高血压合并体位性低血压患者的临床特点[J].中国卫生标准管理,2017,8(18):34-36.