定期监测心电图和心肌酶早期发现抗精神病药心脏副作用研究

摘要

目的：探讨定期监测心电图和心肌酶对早期发现抗精神病药心脏副作用的意义。方法：以2013年1月至10月住院精神分裂症患者为对象，随机分为两组，研究组49例按计划每周1次定期监测心电图及血清谷草转氨酶（ AST）、乳酸脱氢酶（ LDH）、肌酸磷酸激酶同工酶（ CPK-MB）等3项心肌酶，连续观察4周，而对照组51例按常规仅于治疗前和治疗4周末各检查一次，然后，比较两组4周累计心电图异常检出率、4周累计AST、LDH、CPK-MB异常检出率及异常患者心肌酶检测值和发现时间的差异。结果：研究组4周累计心电图异常检出率（26．5％）显著高于对照组（9．8％，P＜0．05），发现时间（10．2±2．6）d显著早于对照组（14．3±2．9d，P＜0．01）。研究组4周累计AST、LDH、CPK-MB异常检出率显著高于对照组（P＜0．05），异常患者检测值显著低于对照组（P＜0．01）。结论：定期监测心电图和心肌酶，有利于早期发现抗精神病药的心脏副作用。%Objective:To explore the significance of periodically testing electrocardiogram and cardiac muscle enzymes in discovering cardiac side-effects early due to antipsychotics .Method: From January and October in 2013, inpatients with schizophrenia were randomly divided into two groups .The study group ( n=49) were tested electrocardiogram and such three cardiac muscle enzymes as serum aspartate aminotrans -ferase (AST),lactate dehydrogenase (LDH),creatine phosphokinase-MB(CPK-MB) once a week for 4 weeks.The control group(n=51) were routinely tested only before and after four weeks ’ treatment.Then, the differences between the two groups were compared on the total four weeks ’ incidence of abnormal electro-cardiogram and abnormal AST,LDH,CPK-MB and discover time.Result:In the study group,the total four weeks ’ incidence of abnormal electrocardiogram ( 26.5%) showed significantly higher than that in the control one (9.8%,P<0.05),but,the discover time (10.2±2.6 days) showed significantly earlier than that in the control group (14.3±2.9 days,P<0.01).The total four weeks’ incidences of abnormal AST,LDH,CPK-MB in the study group were significantly higher than those in the control group ( P<0.05) , and the detection lev-els showed significantly lower than those in the control group (P<0.01).Conclusion:It’s helpful to period-ically test electrocardiogram and cardiac muscle enzymes in early discovering cardiac side -effects due to anti-psychotics.