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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。

Risk of corrected QT interval prolongation in patients receiving antipsychotics.

作者信息

Rivas Juan Carlos, Galindo-A Juliana, Zambrano Luis Fernando, Miranda-B Carlos Alberto, Ramírez Sandra Milena, Rivas-Grajales Ana María, Hernández-Carrillo Mauricio, Rincón Erika Andrea, Perafán Pablo Eduardo, Gómez-Mesa Juan Esteban

机构信息

Department of Psychiatry, Universidad del Valle, Cali, Colombia.

Department of Psychiatry, Universidad Icesi, Cali, Colombia.

出版信息

Int Clin Psychopharmacol. 2025 Jul 1;40(4):207-213. doi: 10.1097/YIC.0000000000000564. Epub 2024 Jul 31.

Abstract

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.

摘要

抗精神病药物(AP)的使用与体表心电图(ECG)QT间期延长有关。我们的研究旨在确定入住精神科住院单元且需要接受AP治疗的患者中校正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。我们纳入了179名入住哥伦比亚卡利市瓦尔大学医院精神病科的患者。入院时以及入院后第3天和第7天进行心电图检查。测量QT间期,并使用Bazzett公式进行QTc间期校正。在9.5%的患者中观察到在时间点B或C出现QTc间期延长。氯氮平是与QTc间期延长相关最常见的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,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间期的增加幅度更大,表明使用它们时需要进行严格的心电图监测。

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