迟发性运动障碍与急性锥体外系副反应的对照研究

目的　探讨抗精神病药（ Ａ Ｐ Ｄ） 所致的迟发性运动障碍（ Ｔ Ｄ） 的相关因素。方法　用不自主运动量表（ Ａ Ｉ Ｍ Ｓ） 、锥体外系副系反应量表（ Ｒ Ｓ Ｅ Ｓ Ｅ） 评定确认 Ｔ Ｄ、急性锥体外系副反应（ Ｅ Ｐ Ｓ） 存在,建立对照组,对所得临床资料进行统计学分析。结果　 Ｔ Ｄ 组总服药时间长,服药剂量高,高效价药使用多,既往 Ｅ Ｐ Ｓ 次数多,情感性精神障碍患者服药剂量比精神分裂症患者明显低。 Ｔ Ｄ 严重程度与各临床变量无显著性相关。 Ａ Ｉ Ｍ Ｓ≤４ 分者与＞ ４ 分者疗效有显著差异。结论　总服药时间、服药剂量、高效价药、 Ｅ Ｐ Ｓ 次数、情感性障碍与 Ｔ Ｄ 发生密切相关, Ｔ Ｄ严重程度可能存在个体易感性, Ｔ Ｄ 的疗效与其严重程度有关。     

哌泊噻嗪,氟哌啶醇癸酸酯与氟奋乃静癸酸酯治疗精神分裂症？…

目的 验证和比较哌泊噻嗪，氟哌啶醇癸酸酯，氟奋及静癸酸酯三种长效抗精神病制剂对精神分裂症的疗效及副反应。方法 采用多中心，开放随机对照研究，以简明精神病评定量表（ＢＰＲＳ），阳性症状评定量表（ＳＡＰＳ），阴性症状评定量表（ＳＡＮＳ），临床疗效总评量表（ＣＧＩ）和副反应量表（ＴＥＳＳ），锥体外系副反应量表（ＲＳＥＳＥ）综合评定，结果 治疗后哌泊噻嗪组患者的ＣＧＩ－ＳＩ与ＣＧＩ－ＧＩ分值和ＳＡＮＳ量表     

哌泊噻嗪、氟哌啶醇癸酸酯与氟奋乃静癸酸酯治疗精神分裂症的对照研究

建桐翁正【摘要】目的验证和比较哌泊噻嗪、氟哌啶醇癸酸酯、氟奋乃静癸酸酯三种长效抗精神病制剂对精神分裂症的疗效及副反应。方法采用多中心、开放随机对照研究，以简明精神病评定量表（ＢＰＲＳ）、阳性症状评定量表（ＳＡＰＳ）、阴性症状评定量表（ＳＡＮＳ）、临床疗效总评量表（ＣＧＩ）和副反应量表（ＴＥＳＳ）、锥体外系副反应量表（ＲＳＥＳＥ）综合评定。结果治疗后哌泊噻嗪组患者的ＣＧＩＳＩ与ＣＧＩＧＩ分值和ＳＡＮＳ量表总分均低于其它两组，差异均有显著性（Ｐ＜０．０５），而ＢＰＲＳ和ＳＡＰＳ量表总分治疗结束时三组间差异无显著性（Ｐ＞０．０５）。ＴＥＳＳ总分和ＲＳＥＳＥ总分在整个治疗过程中均以氟奋乃静癸酸酯组最高，哌泊噻嗪组最低。结论三组中以哌泊噻嗪对精神分裂症的疗效较好，对阴性症状的改善优于氟哌啶醇癸酸酯组和氟奋乃静癸酸酯组，对阳性症状的疗效近似。哌泊噻嗪组副反应较少，安全度较好     

口服利培酮治疗精神分裂症

为验证利培酮治疗精神分裂症的疗效和安全性，对２０例精神分裂症住院患者给予利培酮４～８ｍｇ／ｄ治疗，疗程８周，以阳性和阴性症状量表（ＰＡＮＳＳ）、大体评定量表（ＧＡＳ）和临床总体印象量表（ＣＧＩ）评定疗效，以锥体外系副反应量表（ＥＳＲＳ）和不良反应量表（ＴＥＳＳ）评定药物不良反应。结果显示，治疗结束时显效率为９０％。利培酮的起效时间在１０天左右，仅有轻度的锥体外系副反应和失眠。提示利培酮对精神分裂症的阳性和阴性症状都有良好的疗效，且安全性较高     

情感性精神障碍患者的药源性锥体外系症状

对情感性精神障碍患者出现药源性锥体外系症状（ＥＰＳ）研究较少，ＥＰＳ与锂盐的关系尚不清楚。有研究发现，接受抗精神病药治疗的情感性精神障碍患者比精神分裂症患者对ＥＰＳ（包括迟发性运动障碍，ＴＤ）有较高的易感性［１］。有关锂盐与ＥＰＳ间的关系，动物实验［...     

多发梗塞性痴呆患者血浆和脑脊液中若干神经肽含量的变化

用放射免疫法测定了３０例多发梗塞性痴呆（ＭＩＤ）、３５例无痴呆多发脑梗塞患者（ＭＣＩ）及３０名健康人的血浆生长抑素（ＳＳ）、精氨酸加压素（ＡＶＰ）及β－内啡肽（β－ＥＰ）含量，同时测定了部分ＭＩＤ和ＭＣＩ患者脑脊液（ＣＳＦ）中ＳＳ、ＡＶＰ、β－ＥＰ含量。发现ＭＩＤ患者血浆ＳＳ、ＡＶＰ含量比ＭＣＩ组和健康对照组均降低（Ｐ＜０．０５），且随痴呆程度的加重，其含量有递减趋势。而血浆中β－ＥＰ在这三组间差异无显著性意义（Ｐ＞０．０５）。ＭＩＤ组ＣＳＦ中ＳＳ、β－ＥＰ含量低于ＭＣＩ组（Ｐ＜０．０５），而ＣＳＦ中ＡＶＰ含量在两组间无差异（Ｐ＞０．０５），ＣＳＦ中ＡＶＰ含量与痴呆的关系有待进一步研究。     

左旋千金藤啶碱治疗精神分裂症初步探讨

目的 探讨国产多巴胺阻滞剂－－克旋千金藤啶碱（Ｌ－ＳＰＤ）治疗精神分裂症的疗产及副作用。方法 对１３例符合ＣＣＭＤ－２－Ｒ诊断标准长期住院的精神分裂症患者,且此药治疗８周以上,用临床大体评定量表（ＧＡＳ）、临床大体印象量表（）ＣＧＩ＿ＧＩ）评定疗效,用副反应量表（ＴＥＳＳ）评定副反应。结果 ＧＡＳ量表分值明显提高,有效率为６９．２％。结论 Ｌ－ＳＰＤ对精神分裂症有一;定疗效,它可能成为唯一国产的抗     

氯氮平与氯丙嗪治疗精神分裂症的对照研究

为进一步验证氯氮平在治疗精神分裂症中的地位。方法对病程＜５年的１２２例首次住院的精神分裂症患者，采用分层随机法分为两组，分别首选氯氮平和氯丙嗪进行８周治疗。以ＢＰＲＳ、ＳＡＰＳ、ＳＡＮＳ评定疗效，以ＴＥＳＳ评定副反应。结果治疗前后比较，两组ＢＰＲＳ、ＳＡＰＳ分均显著下降（Ｐ＜０．０１），ＳＡＮＳ分氯氮平组显著降低（Ｐ＜０．０１），氯丙嗪组无明显差异（Ｐ＞０．０５）；疗后氯氮平组的ＢＰＲＳ、ＳＡＰＳ、ＳＡＮＳ总分均明显低于氯丙嗪组（Ｐ＜０．０１）；ＴＥＳＳ总分氯氮平组亦低于氯丙嗪组，且无锥体外系副反应。结论氯氮平确是一种十分有效且药物副反应并不多见的抗精神病药。在严密监测血象的情况下，氯氮平实际上可作为一个可供选择的治疗精神分裂症的第一线药使用。     

利培酮与氯氮平治疗精神分裂症的对照研究

６０例ＰＡＮＳＳ总分≥６０，符合ＤＳＭ－Ⅳ精神分裂症诊断标准的患者，分别给予利培酮或氯氮平治疗。经８周随机对照研究发现，ＰＡＮＳＳ、ＣＧＩ、ＥＳＲＳ、ＴＥＳＳ量表评定显示，利培酮治疗精神分裂症疗效肯定，有效率９６．７％，与氯氮平相仿。利培酮在治疗１周后起效，阴性症状见效尤早，剂量较小者锥体外系副反应轻，其它不良反应发生率和严重程度较氯氮平明显少而轻，治疗的依从性与生活质量较高。本研究证实，利培酮是     

I型,II型精神分裂症迟发性运动障碍调查分析

对１３０例住院男性精神分裂症患者（Ｉ型５４例、Ⅱ型７６例）的迟发性运动障碍（下称ＴＤ）作了调查。采用阴性症状量表（ＳＡＮＳ）、阳性症状量表（ＳＡＰＳ）、及异常不自主运动量表（ＡＩＭＳ）进行评定，结果表明。ＴＤ的总发生率为１６．９２％（２２／１３０），Ｉ型及Ⅱ型患者ＴＤ的发生率分别为５．５６％（３／５４）和２５％（１９／７６），ＴＤ组阴性症状综合评价总分明显高于非ＴＤ组，ＴＤ的患病率随年龄的增大，服     

Treatment of tardive dyskinesia with donepezil: a pilot study

BACKGROUND: Tardive dyskinesia (TD) remains a significant clinical problem for which there is no uniformly effective treatment. Earlier trials with acetylcholine precursors may have been disappointing because of underlying damage to striatal cholinergic neurons in patients with TD. In contrast, new cholinesterase inhibitors, developed for the treatment of dementia, may improve TD by directly increasing cholinergic synaptic transmission. METHOD: We conducted an 8-week open-label trial of donepezil in the treatment of TD. Ten patients with schizophrenia or schizoaffective disorder who received stable doses of antipsychotics and met DSM-IV criteria for TD were treated with donepezil, 5 to 10 mg/day, for 6 weeks after a 2-week baseline period. Changes in total Abnormal Involuntary Movement Scale (AIMS) scores measured every 2 weeks were assessed for significance. Patients were also assessed using the Brief Psychiatric Rating Scale, the Mini-Mental State Examination, the Barnes Akathisia Scale, and the Simpson-Angus Scale. RESULTS: Total AIMS scores decreased significantly (p = .0009), with no changes in other measures. Nine patients showed a positive response. Improvement was greatest in orofacial and upper extremity movements. No significant interactions were noted between the total AIMS scores and age (p > .29), duration of TD (p > .38), or duration of antipsychotic treatment (p > .14). CONCLUSION: Donepezil appeared to be effective in suppressing TD in this pilot study. However, placebo-controlled, double-blind studies are necessary before donepezil can be recommended as a treatment for TD.     

Tardive drug-induced extrapyramidal syndromes

The clinical features, outcomes, differential diagnoses, epidemiology, risk factors, and treatment approaches to tardive drug-induced extrapyramidal syndromes (EPS) are reviewed. Tardive forms of dyskinesia (TD), dystonia (TDt), akathisia (TA), Gilles de la Tourette syndrome (TGTS), myoclonus (TM), and parkinsonism (TP) are described. Moreover, pharmacological and topographical subtypes of TD are discussed. While TD, TDt, and TA are clearly delineated syndromes, there are limited data on TGTS, TM, and the questionable TP. TDt is distinguished from TD by clinical and treatment-related variables. Epidemiological studies provide evidence of better prognosis for TD compared with both TDt and TA. Two distinct groups of variables were found to be associated with a higher risk for TD: an exogenous factor (neuroleptic treatment variables and alcohol or drug abuse) and a factor of predisposition (elderly, female, affective disorder diagnosis, presence of EPS, diabetes mellitus type II, and signs of central vulnerability). In contrast, being younger and male was associated with TDt. A significant relationship between the hyperkinetic forms of tardive EPS was confirmed. Therapeutic strategy differs for the mild, moderate, and severe forms of tardive EPS. Using low doses of antipsychotics is a good preventive approach. Reducing the dose or switching to an atypical antipsychotic is the usual, but not yet fully explored, first therapeutic step. Clozapine, an antipsychotic with antidyskinetic and antidystonic effectiveness, is the second treatment step. Various suppressors of tardive movements were tested in controlled trials, mainly in TD. GABAergic benzodiazepines (clonazepam), adrenergic antagonists (propranolol, clonidine), antioxidants (alpha-tocopherol), and calcium channel blockers (nifedipine) are useful in the third step of treatment of more severe tardive EPS. Unlike TD, TDt and (partially) TA improve on higher doses of anticholinergic medication. Local injection of botulinum A toxin markedly ameliorates focal tardive dystonia over several months. Less verified therapeutic interventions are discussed.     

Prevalence of movement disorders in adolescent patients with schizophrenia and in relationship to predominantly atypical antipsychotic treatment

Objective To examine prevalence of movement disorders (MDs) such as tardive dyskinesia (TD), parkinsonism or akathisia in an adolescent population with schizophrenia and in relationship to predominantly atypical antipsychotic treatment. Method Ninety-three patients (aged 19.6±2.2 years) were ascertained in this cross-sectional/retrospective study. 76 patients (81.7%) received atypical, 10 (10.8%) typical antipsychotics and 7 (7.5%) combinations of atypical/typical antipsychotics. MD symptoms were assessed using Tardive Dyskinesia Rating Scale (TDRS), Abnormal Involuntary Movement Scale (AIMS), Extrapyramidal Symptom Scale (EPS), Barnes Akathisia Scale (BAS). Results Movement disorder symptoms were found in 37 patients (39.8%) fulfilling strict/subthreshold criteria for TD (5.4/11.8%), parkinsonism (2.2/25.8%) or akathisia (1.1/11.8%), respectively. Patients treated with typical antipsychotics displayed a significantly higher EPS-score (P=0.036) and a tendency towards a higher BAS-score (P=0.061) compared to patients with atypical antipsychotics. Treatment durations with typical/atypical antipsychotics showed trends towards advantages of atypical antipsychotics with regard to parkinsonism/akathisia symptoms (P=0.061; P=0.054), but not with regard to TD symptoms (P=0.003), possibly due to confounding effects. Conclusion Under treatment with atypical antipsychotics MD symptoms are less prevalent and less pronounced than under typical antipsychotics. We speculate that the finding of relatively high prevalence rates of subthreshold MD symptoms may be, at least partially, explained by previous or combined therapy with typical antipsychotics.     

Tardive dyskinesia: who is at risk?

Tardive dyskinesia (TD) has been associated with female gender, affective symptoms and good outcome, but also with negative symptoms, cognitive deterioration and deteriorating illness course. Furthermore, antipsychotic medication is thought to be an important risk factor, yet abnormal movements also occur in patients who have never received such medication. We followed 166 subjects with recent onset of psychotic illness and brief previous exposure to antipsychotic medication. Information on 17 previously reported risk factors was available for 125 patients at baseline and, for factors that vary over time, again at follow-up 4 years later (median, 50 months; interquartile range, 29-70). Movement disorder was assessed at follow-up using the Abnormal Involuntary Movement Scale (AIMS). Six non-interacting variables were independently associated with the 4-year risk of TD: male sex (OR, 2.5; 95% CI, 1.1-5.0), age (OR over quartiles at baseline, 1.6; 95% CI, 1.1-2.2), lack of insight at baseline (OR over four categories, 2.0; 95% CI, 1.2-3.2), time on antipsychotics during the follow-up period (OR over quartiles, 2.3; 95% CI, 1.5-3.4), an increase in negative symptoms during the follow-up period (OR over quartiles, 1.7; 95% CI, 1.2-2.5), and alcohol/drug misuse at follow-up (OR, 3.0; 95% CI, 1.3-7.4). The presence of individual risk factors was found to be of little use as a screening test for subsequent clinically relevant TD. Given the absence of a risk factor, however, the probability that an individual would not develop TD was high. These results suggest that two discrete effects may operate to increase the risk of TD, namely an exogenous factor (medication, drugs), and an illness-related factor, the highest risk being conferred by deteriorating illness course in male patients.     

GSTM1 null genotype as risk factor for late-onset Alzheimer's disease in Italian patients

Once developed, tardive dyskinesia (TD) is a challenging condition to treat. The recent evidence has indicated that zonisamide, an antiepileptic drug indicated for partial-onset seizures, may also have beneficial effects for ameliorating dyskinesia in Parkinson's disease. However, this finding has not systematically been tested in psychiatric patients with TD associated with antipsychotic treatment. The objective of this study was to examine the efficacy, tolerability, and safety of zonisamide against TD in these patients. In this 4-week open-label study, subjects who suffered TD were given 50-100 mg/day of add-on zonisamide. Severity of TD was evaluated at the baseline and endpoint, using the Abnormal Involuntary Movement Scale (AIMS). Eleven subjects (6 females; mean±SD age, 75.5±4.7 years; schizophrenia [N=6], bipolar affective disorder [N=2], schizoaffective disorder [N=1], mental retardation [N=1], mental retardation with epilepsy [N=1]; 6 were antipsychotic free at baseline) participated in this study. The AIMS total score (mean±SD) was significantly decreased from 24.1±5.5 to 19.5±5.9, with 36.4% of the subjects (N=4) demonstrating 20% or more decrease in the AIMS total score. Treatment with zonisamide was well-tolerated and no participants dropped out prematurely. In conclusion, zonisamide may be safe and effective for the treatment of TD associated with antipsychotic treatment. These preliminary findings need to be further explored by larger well-designed trials.     

Clinical correlates of tardive dyskinesia in schizophrenia: baseline data from the CATIE schizophrenia trial

OBJECTIVE: To examine the clinical characteristics of individuals with schizophrenia that develop tardive dyskinesia (TD) associated with antipsychotic treatment. METHODS: Baseline data on 1460 patients with schizophrenia were collected as part of the Clinical Antipsychotic Trials of Intervention Effectiveness schizophrenia study. Subjects who met Schooler-Kane criteria for probable TD were compared to those without TD. Multiple regression analyses were used to examine the relationship between TD and clinical variables. RESULTS: 212 subjects met the Schooler-Kane criteria for probable TD and 1098 had no history or current evidence of TD. Subjects with TD were older, had a longer duration of receiving antipsychotic medication, and were more likely to have been receiving a conventional antipsychotic and an anticholinergic agent. After controlling for important baseline covariates, diabetes mellitus (DM) and hypertension did not predict TD, whereas substance abuse significantly predicted TD. Differences in cognitive functioning were not significantly different after controlling for baseline covariates. The TD subjects also had higher ratings of psychopathology, EPSE, and akathisia. CONCLUSION: Our results confirm the established relationships between the presence of TD and age, duration of treatment with antipsychotics, treatment with a conventional antipsychotic, treatment with anticholinergics, the presence of EPS and akathisia, and substance abuse. Subjects with TD had higher ratings of psychopathology as measured by the PANSS. We found no support for DM or hypertension increasing the risk of TD, or for TD being associated with cognitive impairment.     

Clinical research on antipsychotics in bipolar disorder

Antipsychotics are commonly used in bipolar disorder, both for acute mania and in maintenance treatment. The authors review available clinical research concerning the use of both conventional and atypical antipsychotics in bipolar disorder and present recommendations for a number of key clinical situations based on this review. They also consider a number of important related questions, including whether there is evidence for an increased risk of tardive dyskinesia (TD) in patients with bipolar disorder, the potential role for antipsychotics in the treatment of bipolar depression, the role of antipsychotics in maintenance treatment of bipolar disorder, the potential for antipsychotics to induce depression in bipolar illness, and whether antipsychotics can be considered mood stabilizers with a place as monotherapy for bipolar mania. They conclude that standard treatment for acute mania should begin with a mood stabilizer, with benzodiazepines used as an adjunct for mild agitation or insomnia and antipsychotics used as an adjunct for highly agitated, psychotic, or severely manic patients. They also conclude that atypical antipsychotics are preferable to conventional antispychotics because of their more favorable side effect profile and reduced risk of tardive dyskinesia. They review the evidence for using atypical antipsychotics as first-line monotherapy for mania and conclude that more evidence concerning the risk of TD and their efficacy as maintenance treatment in bipolar disorder is needed before a conclusion can be made. Should the eventual risk of TD associated with atypical antipsychotics be found to be minimal and their efficacy in maintenance treatment found to be high, they could eventually be considered first line monotherapy for bipolar disorder. They conclude that treatment with an antipsychotic during bipolar depression should be limited to those patients who have psychosis and that atypical antipsychotics are preferred over conventional antipsychotics in this situation, not only because of their reduced risk of side effects but also because theoretically they may have antidepressant efficacy due to their effects on the serotonin system. The clinical research findings summarized in the article are, for the most part, supported by a recently published guideline based on a consensus of clinical experts.     

Acute antipyschotic efficacy and side effects in schizophrenia: association with serotonin transporter promoter genotypes

BACKGROUND: The serotonin transporter (5-HTT) plays an important role in serotonergic neurotransmission. In the present study, we investigated the effects of the 44 bp insertion/deletion polymorphism in the promoter region of 5-HTT gene (5-HTTLPR) on symptomatology of psychosis and clinical response to antipsychotic drugs. METHODS: In total 56 patients acutely treated with haloperidol or risperidone either for the first episode of schizophrenia, schizophreniform or schizoaffective disorders, or for the relapse of these psychotic disorders after tapering their maintenance treatment, were genotyped for the 5-HTTLPR L and S alleles and for the new A/G functional variant within the L alelle (La/g). Psychopathological symptoms were assessed with the Brief Psychiatric Rating Scale (BPRS) and with Clinical Global Impression (CGI) twice: at 8-12 days after the first dose of antipsychotic and after 4 weeks. Extrapyramidal side effects were assessed with the Simpson-Angus Extrapyramidal Side Effects Scale (EPS), the Barnes Akathisia Scale (BARS) and the Abnormal Involuntary Movement Scale (AIMS). RESULTS: Age, body mass index (BMI), illness duration, drug type and dosage were considered as covariates when analysing association with genetic variants as they were associated with baseline or final BPRS and CGI scores and/or extrapyramidal side effects. 5-HTTLPR was not associated with baseline and final BPRS and CGI scores or with the CGI% reduction. However, the 5-HTTLPR S allele was associated with a lower improvement in BPRS scores (P=0.022) and this effect was even stronger after pooling subjects with S or Lg containing alleles (P=0.006). We did not observe any effect of 5-HTTLPR on acute antipsychotics side effects. CONCLUSION: Present result supports a contribution of serotonin system to neuroleptics efficacy for the treatment of schizophrenia. The analysis of the La/g functional variant may significantly improve the predictive power of 5-HTTLPR genotyping and represent a step further towards the development of the personalized antipsychotic treatment.     

Anticholinergic use in hospitalised schizophrenic patients in Belgium

This naturalistic study aims to evaluate the influence of antipsychotic treatment on the use of anticholinergics. The observed use of anticholinergics will give an indication of the occurrence of extrapyramidal side effects (EPS) in the different antipsychotic treatment conditions. The medication use of 1215 hospitalised patients with DSM-IV 295.xx diagnosis is recorded. Four antipsychotic treatment conditions are distinguished: 1) only first generation antipsychotics (FGA): patients receive one or a combination of first generation antipsychotics, 2) a combination of high potency FGA and second generation antipsychotics (SGA), 3) a combination of low potency FGA and SGA, and 4) only SGA: patients receive one or a combination of SGA. Antipsychotic treatment significantly influences the use of anticholinergics. Anticholinergic use is highest in patients treated with high potency FGA (whether or not in combination with SGA) as compared with patients only treated with SGA and patients combining SGA with low potency FGA. The two latter groups do not significantly differ. However, there were no significant differences in the prevalence of EPS with the exception of akathisia between FGA and SGA. Thus, through the use of anticholinergics, EPS induced by FGA can be effectively reduced.     

抗精神病药致首发精神疾病QTc 间期变化的相关 因素分析

目的 调查抗精神病药致首发精神疾病QTc间期延长的影响因素.方法 对服用稳定剂量抗精神病药治疗1月的309例首发精神疾病患者进行回顾性调查,收集人口学资料、空腹血糖、血压、血脂等生化指标、心电图资料,以QTc≥440ms作为QTc间期延长的标准,分析QTc间期延长的状况及其相关因素.结果 QTc间期延长的发生率为10.6%.药物治疗组QTc间期均值大于基线期,差异有统计学意义(P<0.05);药物联合电休克治疗组以及药物联合脑电治疗组QTc间期与基线期相比,差异无统计学意义(P>0.05).单一抗精神病药治疗组QTc间期与基线期差异无统计学意义(P>0.05);而抗精神病药联用以及抗精神病药联用抗抑郁药/心境稳定剂组QTc间期均值大于基线期,差异有统计学意义(P<0.05).抗精神病药等效氯丙嗪剂量<1000mg/d组别QTc间期与基线期相比差异有统计学意义(P<0.05).抗精神病药剂量与QTc间期没有相关性.女性是QTc间期延长的风险因素(OR=3.26,95%CI=1.050~10.094),其他因素未进入回归方程.结论 首发精神疾病患者抗精神病药治疗期间QTc间期延长存在性别差异,女性发生QTc间期延长的风险是男性的3.26倍.药物联用延长的QTc间期并未达到异常值.抗精神病药剂量与QTc间期没有相关性.除了性别因素外,其他指标不是QTc间期延长的风险因素.