氯氮平所致心脏毒副反应及危险因素研究-精神病与精神卫生专业毕业论文.docxVIP

南京医科大学硕士学位论文氯氮平所致心脏毒副反应及危险因素分析 南京医科大学硕士学位论文 氯氮平所致心脏毒副反应及危险因素分析 【摘要】目的：探讨氯氮平对心脏毒副反应及可能的危险因素。 方法：采用病例对照研究分析400例服用氯氮平的住院患者中51例 产生心脏严重副反应的危险因素，包括性别、年龄、服用氟氮平治疗 前的基础体重、血压、躯体疾病尤其是心血管疾病、服药时间、剂量 及其血药浓度、合并用药等。 憎果：Logistic回归分析表明影响心 、 脏发生毒副反应的因素依次为：治疗前心律失常、治疗中合用精神药 物≥3种、治疗前T波异常、服氯氮平时间，治疗中合用某些抗抑郁 药物与其亦有相关性。J|结论：氯氮平治疗精神疾病中会出现一些严 ， 重副反应，甚至可导致心源性猝死，临床上在注意其疗效外应尽可能 避免危险因素。 【关键词】 氯氮平； 血清氯氮平浓度； 心脏毒副反应； 心电 图：危险因素 An analysis of the cardiac adverse and toxic responses to treatment with clozapine and the associated risk factors 南京医科大学硕士学位论文[Abstract]Objective：To 南京医科大学硕士学位论文 [Abstract]Objective：To explore the cardiac adverse and toxic responses to treatment with clozapine and the associated risk factors． Method：400 inpatients were treated with clozapine for weeks and measured in Serum clozapine concentration and electrocardiogram．We compared age，sex，pre—drugs，CO—drugs condition of pretherapy and time of applied clozapine between patients with side effects and without Results：The results showed that the major factors related to the川effects were as follows：cardiac arrhythmja before therapy．accompanied drugs(≥ 3)，T in ECG，applied time of clozapine．Conclusion：Overa risk factors might cause heart rate variability，cardiac arrest and ventricular arrhythmia in patients taking antipsychoticdrugs．The QT interval when lengthened has been implicated as a risk factor for the development of sudden death，particularly in patients predisposed to these complications due to cardiovascular mpairment．Such effects could contribute to the clinical effects of atypical antipsychotic drugs in patients．The ability to make optima choices will depend on determining effecls and side effects．Care should be taken in prescribing clozapine to patients prone to cardiOvascuIar side effects 【Key words】Clozapine；Serum clozapine concentration cardiac responses； EIectrOca删Ogram： Risk factor 一2一 南京医科大学硕士学位论文引言 南京医科大学硕士学位论文 引言 近年来国内外对氯氮平的研究多集中在临床长期应用可能引起 的副作用和相关疾病，如体重增加、II型糖尿病、性功能障碍等，氯 氮平治疗对