复方丹参滴丸治疗抗精神病药所致QTc间期延长临床研究 朱毅平 卢.doc

复方丹参滴丸治疗抗精神病药所致QTc间期延长临床研究 朱毅平 卢胜利 周虎江 浙江省湖州市第三人民医院 湖州313000 摘要：目的：探讨复方丹参滴丸治疗抗精神病药所致QTc间期延长的疗效及可能机制。方法：首发精神分裂症急者，单一服用某种抗精神病药，首次复查ECG出现QTc＞440ms者作为研究对象，给复方丹参滴丸口服，服药期间抗精神病药剂量不变。每周末复查ECG、血K4+、心率 HR ，研究周期为3周。结果：服用氯氮平、利培酮、舒必利、氯丙嗪等药都可发生QTc间期延长，平均时间为 18.3±4.5 d。经服用复方丹参滴丸后，QTc间期与治疗前比较有明显缩短，差异非常显著 P＜0.01 ，经比较以第1、2周缩短最为显着 P＜0.01 ；治疗前后HR、血K+无明显变化 P＞0.05 。结论：复方丹参滴丸治疗本病疗效确切，可能与心肌细胞内外的离子分布异常得到及时纠正有关。 关键词：复方丹参滴九；精神分裂症；抗精神病药；QTc间期延长 Abstract: Objective: To study the efficiency and possible mechanism of QTc prolonging resulted from the antipsychotic drugs together with Composite Salviae Dropping Pill. Methods: The first-episode of schizophrenia were chosen.Anal they took only one kind of antipsychotic drugs. The QTc of ECG ＞440ms were to be studied.They were asked to taken 10 pills three times a day affer meals. At the same time they took the antipsychotic drygs like before.They had ECG,blood K+ and HR tested every weekend. Results: Taking Clozapine, Risperldone, Sulpiride and Chlorpromazine resulted in prolonging QTc and the average was 18.3?.5days QTc is shortened by taking Composite Salviae Dropping Pill P＜0.01 .It was obvious in the 1 st and 2nd weeks during the test P＜0.01 .HR and blood K+ almost kept the same before and after the treatment ＞0.05 .Conclusion: It is certain that Composite Salvize Dropping Pill can prolong QTc when it is used to treat Antipsychotic drugs and it is likely to have something to do with the correction of the abnormal ion distribution in and out of cardiac muscle cells. Key words: Composite Salviae Dropping Pill; Schizophrenia; AntiPsychotiC drugs; QTc prolonging 中图分类号：R 749．3 文献标识码：B 文献编号：1671-4040 2004 02-0003-02 根据文献报道，目前绝大多数的抗精神病药物都可引起心电图 ECG 的异常，ECG异常中的QTc延长也十分常见，且有时相当严重，甚至可发生碎死。我们进行了前瞻性的复方丹参滴丸治疗抗精神病药物所致QTc延长的研究，并对其可能的机制进行了探讨。 1 对象与方法 1．1 对象 资料来自本院因精神病住院的患者。入组患者符合： 1 中国精神疾病分类与诊断标准第3版 CCMD—3 的精神分裂症诊断标准。 2 年龄在18～40岁之间：首次发病，入院前2周未服过任何抗精神病药。 3 女性患者为非妊娠期、哺乳期。 4 既往无心、肝、内分泌、神经系统等疾病史，无精神活性物质及药物滥用史。 5 入院时体检正常，血、尿常规，血脂、肝、肾功能及心、脑电图，脑部CT均