非典型抗精神病药物对精神分裂症患者心电图QT间期的影响

目的评价非典型抗精神病药物对精神分裂症患者心电图QT间期的影响。方法对153例单一口服非典型抗精神病药物治疗的精神分裂症患者，于治疗前及治疗药物达临床最大剂量时进行心电图检查，对心电图QT／QTc间期进行对比分析。结果非典型抗精神病药物喹硫平、利培酮、阿立哌唑治疗后QT／QTc间期与治疗前比较均无显著性差异（P〉0．05）；氯氮平治疗后QT／QTc间期均较治疗前显著缩短（t=5．294、3．243，P〈0．01）。治疗前不同药物组QT／QTc间期经方差分析均无显著性差异，治疗后不同药物组QT间期有显著性差异（F=8．759，P=0．000）；两两比较显示，治疗后QT间期平均值利培酮组、阿立哌唑组〉氯氮平组（P〈0．01）；不同药物治疗后QT间期平均值长短顺序依次为利培酮〉阿立哌唑〉喹硫平〉氯氮平。结论不同非典型抗精神病药物对心电图的QT／QTc间期有不同程度的影响，利培酮组的QT间期最长，氯氮平组最短。

Influences of atypical antipsychotics on QT intervals of schizophrenics

Objective To evaluate the effects of atypical antipsychotics on QT intervals of schizophrenics. Methods ECGs were carried out and QT/QTc intervals contrasted and analyzed in 153 schizophrenics who took orally single atypical antipsychotics before treatment and when used drugs reached clinical maximal dose. were selected. Results After treatment of atypical antipsychotics such as quetiapine,risperidone and aripiprazole, there were no significant differences in QT/QTc intervals compared with pretreatment（P〉 0.05）; after clozapine treatment, QT/QTc intervals shortened more significantly（t = 5. 294,3. 243, P〈 0.01）. Before treatment, there were no significant differences in variance analyses of QT/QTc intervals among different drug groups, after treatment the results turned out contrary to pretreatment in QT intervals（F=8. 759,P=0. 000）;two-two comparisons showed that after treatment the mean values of the QT intervals was greater in both risperidone and aripiprazole than in clozapine group（both P〈0.01） ; after different drug tratment the mean value of the QT intervals was in order risperidone〉aripiprazole〉quetiapine〉clozapine. Conclusion Different atypical antipsychotics have effects in varying degrees on QT/QTc intervals;after treatment, the QT intervals of risperidone are the longest and those of clozapine the shortest.