接受抗精神病药物治疗的患者出现校正 QT 间期延长的风险。

IF 2.1 3区 医学 Q3 PHARMACOLOGY & PHARMACY International Clinical Psychopharmacology Pub Date : 2024-07-31 DOI:10.1097/YIC.0000000000000564
Juan Carlos Rivas, Juliana Galindo-A, Luis Fernando Zambrano, Carlos Alberto Miranda-B, Sandra Milena Ramírez, Ana María Rivas-Grajales, Mauricio Hernández-Carrillo, Erika Andrea Rincón, Pablo Eduardo Perafán, Juan Esteban Gómez-Mesa
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引用次数: 0

摘要

抗精神病药物(AP)的使用与表面心电图(ECG)上的 QT 间期延长有关。我们的研究旨在确定需要接受抗精神病药物治疗的精神病住院患者中校正 QT(QTc)间期延长的发生率,并评估给药剂量与 QTc 间期变化之间的关系。我们招募了 179 名哥伦比亚卡利市 Valle 大学基础精神病医院的住院患者。入院时进行心电图检查,入院后 3 天和 7 天再次进行心电图检查。测量 QT 间期,并使用巴兹特公式对 QTc 间期进行校正。9.5%的患者在B或C时间点观察到QTc间期延长。氯氮平是最常见的与 QTc 间期延长相关的 AP(20.59%),其次是奥氮平(15.38%)。与氟哌啶醇相比,氯氮平导致QT间期延长的相对风险为4.17(95%置信区间为1.14-15.17,P = 0.02)。入院时使用 AP 与早期(3 天内)QTc 间期延长有关。与氟哌啶醇相比,氯氮平和奥氮平与 QTc 间期延长的相关性更大,这表明在使用这两种药物时需要进行严格的心电图监测。
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Risk of corrected QT interval prolongation in patients receiving antipsychotics.

Antipsychotic (AP) use has been associated to QT interval prolongation on the surface electrocardiogram (ECG). Our study aimed to determine the incidence of corrected QT (QTc) interval prolongation among patients admitted to a psychiatric hospitalization unit requiring AP treatment and to assess the relationship between administered dose and QTc interval changes. We enrolled 179 patients admitted to the Hospital Psiquiátrico Departamental Universitario del Valle in Cali, Colombia. ECGs were conducted upon admission, and again at 3 and 7 days postadmission. The QT interval was measured, and QTc interval correction was performed using Bazzet's formula. QTc interval prolongation at time points B or C was observed in 9.5% of patients. Clozapine was the most common AP associated with QTc interval prolongation (20.59%), followed by olanzapine (15.38%). The relative risk of QT interval prolongation with clozapine compared to haloperidol was 4.17 (95% confidence interval, 1.14-15.17, P = 0.02). AP use upon hospital admission was linked to early (within 3 days) QTc interval prolongation. Clozapine and olanzapine were associated with a greater increase in QTc interval compared to haloperidol, indicating a need for rigorous electrocardiographic monitoring with their use.

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来源期刊
CiteScore
4.40
自引率
23.10%
发文量
97
审稿时长
>12 weeks
期刊介绍: International Clinical Psychopharmacology provides an essential link between research and clinical practice throughout psychopharmacology. It reports on studies in human subjects, both healthy volunteers and patients, which relate the effects of drugs on psychological processes. A major objective of the journal is to publish fully refereed papers which throw light on the ways in which the study of psychotropic drugs can increase our understanding of psychopharmacology. To this end the journal publishes results of early Phase I and II studies, as well as those of controlled clinical trials of psychotropic drugs in Phase II and IV. Other topics covered include the epidemiology of psychotropic drug prescribing and drug taking, the sociology of psychotropic drugs including compliance, and research into the safety and adverse effects of these compounds.
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