阿立哌唑氯氮平喹硫平对康复期精神分裂症心肌酶和心电图的影响

目的 评价阿立哌唑、氯氮平及喹硫平对康复期精神分裂症患者心肌酶和心电图的影响.方法检测单一服用阿立哌唑(30例)、氯氮平(30例)、喹硫平(30例)治疗≥2 a的康复期精神分裂症患者的血清心肌酶及心电图,并进行对比分析.结果 3组间两两比较显示,(1)服药时间:阿立哌唑组服药时间显著小于氯氮平组和喹硫平组(P＜0.05),氯氮平组与喹硫平组差异无显著性(P＞0.05);(2)心肌酶变化:氯氮平组肌酸激酶同工酶显著高于阿立哌唑组与喹硫平组(P＜0.01),阿立哌唑组显著高于喹硫平组(P＜0.05);(3)心电图改变:3组心电图改变以窦性心动过速、T波改变最为常见,阿立哌唑组异常率13.3%、氯氮平组异常率86.7%、喹硫平组异常率为16.7%,氯氮平组异常发生率最高,3组差异有极显著性(H=9.5,P＜0.01).结论阿立哌唑、氯氮平及喹硫平对康复期精神分裂症患者的心肌酶和心电图均可产生一定的影响,但氯氮平影响更为显著,可能与氯氮平有极强的抗胆碱作用有关.

Effects of aripiprazole, clozapine and quetiapine treatment on myocardial enzymogram and electrocardiogram in convalescence schizophrenia

Objective To evaluate the effects of aripiprazole, clozapine and quetiapine treatment on myo- cardial enzymogram and electrocardiogram （ECG） in convalescence schizophrenics. Methods Serum myocardial enzymogram were determined and Ecg examined in schizophrenics who took single aripiprazole （n= 30）, clozapine （n=30） or quetiapine （n=30） more than two years, and findings contrastively analyzed. Results Group comparisons showed that （1） drug administration duration was significantly shorter in aripiprazole group than in both clozapine and quetiapine groups （P〈0.05）, wasn＇t significant difference between clozapine and quetiapine group （P〉0.01） ; （2） the serum isoenzyme level of CK-MB was significantly higher in clozapine group than in the other two groups （P〈0.01） and in the aripiprazole than in quetiapine group（P〈0.05） ; （3） Ecg changes of the 3 groups were mainly sinus tachycardia and T wave alteration, abnormal rates were 13.3% in aripiprazole, 86.7% in clozapine and 16.7% in quetiapine group respectively, abnormal rate in clozapine group was the highest, and differences were very significant among 3 groups （H=9.5, P〈0.01）. Conclusion All aripiprazole, clozapine and quetiapine have certain effects on myocardial enzymogram and Ecg, but clozpaine has more notable effects which are possibly related to its very strong cholinolytic action.