Xiang Yu-Tao, Chiu Helen F K, Ungvari Gabor S, Correll Christoph U, Lai Kelly Y C, Wang Chuan-Yue, Si Tian-Mei, Lee Edwin H M, He Yan-Ling, Yang Shu-Yu, Chong Mian-Yoon, Kua Ee-Heok, Fujii Senta, Sim Kang, Yong Michael K H, Trivedi Jitendra K, Chung Eun-Kee, Udomratn Pichet, Chee Kok-Yoon, Sartorius Norman, Tan Chay-Hoon, Shinfuku Naotaka
Faculty of Health Sciences, University of Macau, Macao, Special Administrative Region, China; Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, Special Administrative Region, China.
Hum Psychopharmacol. 2015 Mar;30(2):94-9. doi: 10.1002/hup.2458. Epub 2015 Jan 22.
Little is known about the pattern of QT interval (QTc) prolongation in Asian patients with schizophrenia. This study examined trends of QTc prolongation in schizophrenia inpatients in six Asian countries and territories between 2004 and 2008/2009 and its independent demographic and clinical correlates.
Data on 3482 hospitalized schizophrenia patients (2004 = 1826 and 2008/2009 = 1656) in six Asian countries and territories were collected by either chart review or interviews during a 1-month period. Patients' sociodemographic and clinical characteristics, prescriptions of psychotropic drugs, and QTc interval were recorded using a standardized protocol and data collection procedure.
The frequency of QTc prolongation (>456 ms) was 2.4% in the whole sample, decreasing from 3.1% in 2004 to 1.6% in 2008/2009 (p = 0.004) with wide intercountry variations. However, this decreased trend was driven by decreased QTc prolongation detected in China and Hong Kong (both p-values < 0.05). Multiple logistic regression analysis of the whole sample revealed that patients having more likely to have an illness lasting longer than 5 years and received antipsychotics classified as list-1 drugs according to the Arizona Centre for Education and Research on Therapeutics. Compared with 2004, patients in 2008/2009 were less likely to have QTc prolongation. Thioridazine caused QTc prolongation most frequently (odds ratio (OR) 4.4; 95% confidence interval (CI) 1.2-15.2), followed by sulpiride (OR 2.4; 95% CI 1.3-4.5), clozapine (OR 2.4; 95% CI 1.4-4.2), and chlorpromazine (OR 1.9; 95% CI 1.07-3.5).
Frequency of QTc prolongation was low in Asian patients with schizophrenia. QTc prolongation in schizophrenia decreased in China and Hong Kong between 2004 and 2008/2009 but increased in Taiwan over the same period, remaining low in the other countries.
关于亚洲精神分裂症患者QT间期（QTc）延长模式的了解甚少。本研究调查了2004年至2008/2009年间六个亚洲国家和地区精神分裂症住院患者QTc延长的趋势及其独立的人口统计学和临床相关因素。
在为期1个月的时间内，通过病历审查或访谈收集了六个亚洲国家和地区3482例住院精神分裂症患者的数据（2004年=1826例，2008/2009年=1656例）。使用标准化方案和数据收集程序记录患者的社会人口统计学和临床特征、精神药物处方以及QTc间期。
整个样本中QTc延长（>456毫秒）的频率为2.4%，从2004年的3.1%降至2008/2009年的1.6%（p=0.004），国家间差异很大。然而，这种下降趋势是由中国和香港检测到的QTc延长减少所驱动的（p值均<0.05）。对整个样本进行的多因素logistic回归分析显示，病程超过5年且接受了根据亚利桑那治疗教育与研究中心分类为1类药物的抗精神病药物治疗的患者更有可能出现QTc延长。与2004年相比，2008/2009年的患者出现QTc延长的可能性较小。硫利达嗪导致QTc延长的频率最高（比值比（OR）4.4；95%置信区间（CI）1.2 - 15.2），其次是舒必利（OR 2.4；95%CI 1.3 - 4.5）、氯氮平（OR 2.4；95%CI 1.4 - 4.2）和氯丙嗪（OR 1.9；95%CI 1.07 - 3.5）。
亚洲精神分裂症患者中QTc延长的频率较低。2004年至2008/2009年间，中国和香港精神分裂症患者的QTc延长情况有所下降，但同期台湾地区有所上升，其他国家仍保持在较低水平。
