Ilgenli T Fikret, Congologlu Ayhan, Ozturk Cengiz, Turkbay Tumer, Akpinar Onur, Kilicaslan Fethi
Department of Cardiology, Golcuk Army Hospital, Golcuk, Kocaeli, Turkey.
Adv Ther. 2007 Jan-Feb;24(1):182-8. doi: 10.1007/BF02850007.
Among childhood psychiatric disorders, attention deficit hyperactivity disorder (ADHD) is of greatest interest to practitioners. Methylphenidate (MPH) is a drug that is widely used in the treatment of children in whom ADHD has been diagnosed. Although this treatment has been used for years, its effects on the heart remain the subject of debate. The QT interval comprises the ventricular activation and recovery periods as seen on electrocardiogram (ECG). The acute effect of MPH on QT interval dispersion is unknown. Researchers in the present study sought to investigate the acute effects of MPH on QT interval as seen on ECG. A total of 25 patients with ADHD (mean age, 9.4+/-2.1 y) who were treated with MPH were enrolled in the study. Twelve-lead derivation ECGs were taken before and 2 h after administration of 10 mg of MPH. Maximum QT interval, minimum QT interval, and interval durations were measured, and QT dispersion was calculated, for each ECG. QT dispersion measured after medication administration decreased significantly from 59.6+/-16.3 ms to 50.8+/-10.9 ms (P=.016); corrected QT dispersion decreased significantly from 70.9+/-17.6 ms to 61.3+/-13.3 ms (P=.011). Maximum QT interval duration decreased from 73.7+/-21.8 ms to 361.8+/-29.0 ms (P=.006); minimum QT interval duration rose from 317.0+/-23.3 ms to 322.3+/-21.6 ms (P=.312). In conclusion, the findings of this study show that MPH reduces QT dispersion during the acute period shortly after its administration.
在儿童精神疾病中，注意力缺陷多动障碍（ADHD）最受从业者关注。哌甲酯（MPH）是一种广泛用于治疗已确诊患有ADHD儿童的药物。尽管这种治疗方法已使用多年，但其对心脏的影响仍存在争议。QT间期包括心电图（ECG）上显示的心室激动和恢复时间。MPH对QT间期离散度的急性影响尚不清楚。本研究的研究人员试图调查MPH对ECG上QT间期的急性影响。共有25名接受MPH治疗的ADHD患者（平均年龄9.4±2.1岁）纳入本研究。在给予10mg MPH前及给药后2小时记录12导联心电图。测量每次心电图的最大QT间期、最小QT间期和间期持续时间，并计算QT离散度。给药后测量的QT离散度从59.6±16.3ms显著降低至50.8±10.9ms（P = 0.016）；校正QT离散度从70.9±17.6ms显著降低至61.3±13.3ms（P = 0.011）。最大QT间期持续时间从73.7±21.8ms降至361.8±29.0ms（P = 0.006）；最小QT间期持续时间从317.0±23.3ms升至322.3±21.6ms（P = 0.312）。总之，本研究结果表明，MPH在给药后短期内的急性期可降低QT离散度。
