氯氮平的心脏不良反应

目的：探讨氯氮平治疗精神疾病时的心脏不良反应及危险因素。方法：分析400例服用氯氮平治疗的患者心电图异常改变及其影响因素。结果：服用氯氮平的患者中出现窦性心动过速(发生率79％)、心律失常及传导障碍(4、5％)、ST段压低(3、8％)、T波异常(36．5％)、QTc间期延长(16．3％)等心电图异常。其严重异常发生率为24．3％。服氯氮平出现心脏严重不良反应的危险因素有：男性、合并心血管疾病、治疗前T波异常、服药剂量较大、服药早期。结论：氯氮平的心脏不良反应较常见，约1／4患者可出现严重心电图异常。氯氮平不宜作为首选用药，使用时应定期监测心电图。

An analysis of the cardiac side effects associated with clozapine

Objective:To explore the cardiac adverse effects treated with clozapine and the associated risk factors in schizophrenic patients. Method:400 inpatients were treated with clozapine.Serum clozapine concentration and electrocardiogram(ECG)were examined.Some factors were compared,which included age,sex,cardiovascular situation before and after treatment, physical condition before therapy, duration of taking clozapine and therapeutic doses between patients with and without cardiovascular adverse effects. Results:The results showed that the side effects included tachycardia, arrhythmia,ST and T-wave abnormalities,QTc interval prolongation.The major factors related to the side effects were as followings:male, pre-existing T-wave abnormalities in ECG,dose and duration of taking clozapine. Conclusion:Care should be taken in prescribing clozapine to patients who are prone to cardiovascular side effects.