Hayashi T, Nishikawa T, Koga I, Uchida Y, Yamawaki S
Department of Psychiatry and Neurosciences, Hiroshima University School of Medicine, Japan.
Clin Neuropharmacol. 1996 Oct;19(5):390-8. doi: 10.1097/00002826-199619050-00002.
We explored the prevalence of respiratory dyskinesia (RD), diagnosed objectively using a spirograph, and the major risk factors for tardive dyskinesia (TD) and RD. A total of 258 inpatients treated with neuroleptics was interviewed, and TD was evaluated using the Abnormal Involuntary Movement Scale (AIMS). Movement of the chest and respiratory regularity were assessed on clinical examination. Spirographs of patients with suspected RD were recorded, and RD was diagnosed based on spirographic data and the concurrence of two investigators. The prevalence of TD in this study was 22.1% (57 of 258). Aging and organic brain damage (OBD) were confirmed as risk factors; female gender, mood disorders, and the duration of neuroleptic exposure were not. Ten of 28 patients suspected of having RD were diagnosed with RD on the basis of persistent respiratory irregularities without other physiologic causes. The overall prevalence of RD was 3.9% (10 of 258) and was 17.5% (10 of 57) among the TD patient population. Four of these patients complained of dyspnea, and three demonstrated grunting. RD was more highly associated with aging and OBD than with TD itself. The identification of risk factors for RD is not only helpful in planning prophylactic strategies, but also facilitates the understanding of the pathogenesis of this syndrome.
我们探讨了使用肺量计客观诊断的呼吸运动障碍（RD）的患病率，以及迟发性运动障碍（TD）和RD的主要危险因素。共对258例接受抗精神病药物治疗的住院患者进行了访谈，并使用异常不自主运动量表（AIMS）评估TD。通过临床检查评估胸部运动和呼吸规律。记录疑似RD患者的肺量计数据，并根据肺量计数据和两位研究者的一致意见诊断RD。本研究中TD的患病率为22.1%（258例中的57例）。年龄增长和器质性脑损伤（OBD）被确认为危险因素；女性、情绪障碍和抗精神病药物暴露时间则不是。28例疑似RD的患者中有10例基于持续性呼吸不规则且无其他生理原因被诊断为RD。RD的总体患病率为3.9%（258例中的10例），在TD患者群体中为17.5%（57例中的10例）。这些患者中有4例主诉呼吸困难，3例表现为呼噜声。RD与年龄增长和OBD的关联比与TD本身的关联更强。确定RD的危险因素不仅有助于制定预防策略，还能促进对该综合征发病机制的理解。
