Correll Christoph U, Harris Jennifer, Figen Vicki, Kane John M, Manu Peter
North Shore-Long Island Jewish Health System, The Zucker Hillside Hospital, Glen Oaks, New York 11004, USA.
J Child Adolesc Psychopharmacol. 2011 Aug;21(4):365-8. doi: 10.1089/cap.2011.0024. Epub 2011 Aug 8.
The rate-corrected QT interval (QTc) prolongation is a risk factor for sudden cardiac death and may be induced by antipsychotic drugs.
To determine the clinical characteristics associated with QTc prolongation (440 msec or greater) in children and adolescents hospitalized for treatment of psychiatric disorders.
We determined the frequency of baseline prolongation of QTc in 811 psychiatric pediatric inpatients (15.5 ± 2.4 years of age). QTc duration was 440 msec or greater (range 441-481 msec) in 16 patients (1.97%). In a 1:5 nested case-control design, the 16 patients with prolonged QTc were age- and gender-matched with 80 patients with QTc of <421 msec.
Patients with normal and prolonged QTc had similar utilization of antipsychotics (43.8% vs. 40.8%) and daily chlorpromazine equivalents (165 ± 110 vs. 168 ± 218 mg). Hypokalemia (p = 0.009) and obesity (p = 0.032) were more common among patients with prolonged QTc. The correlation between obesity and QTc prolongation was confirmed in logistic regression analysis.
In a large cohort of youth hospitalized for treatment of psychiatric disorders, a prolonged QTc on admission was rare and correlated with the presence of obesity, but not with current use of antipsychotic drugs.
校正心率后的QT间期（QTc）延长是心源性猝死的一个危险因素，且可能由抗精神病药物诱发。
确定因精神疾病住院治疗的儿童和青少年中与QTc延长（440毫秒或更长）相关的临床特征。
我们测定了811名精神科儿科住院患者（年龄15.5±2.4岁）QTc基线延长的频率。16名患者（1.97%）的QTc持续时间为440毫秒或更长（范围441 - 481毫秒）。在1:5巢式病例对照设计中，16名QTc延长的患者与80名QTc<421毫秒的患者进行年龄和性别匹配。
QTc正常和延长的患者在抗精神病药物使用情况（43.8%对40.8%）和每日氯丙嗪等效剂量（165±110对168±218毫克）方面相似。低钾血症（p = 0.009）和肥胖（p = 0.032）在QTc延长的患者中更为常见。逻辑回归分析证实了肥胖与QTc延长之间的相关性。
在一大群因精神疾病住院治疗的青少年中，入院时QTc延长很少见，且与肥胖有关，但与当前使用抗精神病药物无关。
