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Received:June 21, 2019 Published Online:March 20, 2020
Received:June 21, 2019 Published Online:March 20, 2020
中文摘要: 目的 分析抗精神病药物对精神分裂症患者血钾水平的影响,为临床采取科学化治疗措施提供参考依据。方法 回顾性分析对2012年12月至2018年12月精神科收治的1 248例精神分裂症患者的临床资料,分别对入院第1天、用药4周、8周血钾检测结果和性别、年龄、病程等临床资料进行统计分析。结果 1 248例精神分裂症患者血钾降低占比为59.62%(744/1 248)。744例中,病程5年以内［450例(60.48%)］和10年以上的患者［198(26.61%)］所占比例相对较高;男性多于女性(2.43[DK]∶1);青年人(18~44岁)比例最高,为486例(65.32%)。用药品种所致血钾降低(发生血钾降低例数/用药例数)具体如下:奥氮平(210/240),喹硫平(126/192),利培酮(84/156),合并用药(246/450),氨磺必利(36/114),阿立哌唑(24/66),氯氮平(18/30)例。1 248例患者用药4周后血钾水平检测结果低于入院后第1天［(3.98±0.32)mmol/L vs (4.19±0.33)mmol/L,P<0.01］,用药8周后血钾水平［(4.16±0.35)mmol/L］与入院比较差异无统计学意义(P>0.05)。用药4周后血钾水平均值最低为氯氮平,其次为奥氮平,最高为氨磺必利。结论 对于血钾偏低的精神分裂症患者,特别是病程5年以内或10年以上的男性18~44岁青年,应在住院1个月内密切关注血钾浓度变化,并尽量使用对血钾浓度影响较小的药物治疗,以减少药物反应,保证医疗安全。
Abstract:Objective To analyze the influences of antipsychotics on the serum potassium level in the patients with schizophrenia to provide reference for clinical treatment measures. Methods A retrospective analysis was performed in the clinical data of 1 248 patients with schizophrenia admitting to the psychiatry department from December 2012 to December 2018. The serum potassium levels on the first day of admission, 4- and 8- week after medicine, gender, age, course of disease and other clinical conditions of the patients were analyzed statistically.
Results In 1 248 patients, there were 744 with decreased serum potassium (59.62%). The patients with disease duration of less than 5 years [450 (60.48%)] and over 10 years [198 (26.61%)] were in the majority. The proportion of men was more than women(2.43∶1), with the highest proportion [488 (65.32%)] of young people (18-44 years old). The incidence rates of hypokalemia caused by medications (the number of hypokalemia cases/the number of drug cases) were respectively 87.50% in olanzapine (210/240), 65.63% in quetiapine(126/192), 53.85% in risperidone (84/156), 54.67% in combined medication(246/450), 31.58% in amisulpride (36/114), 36.36% in aripiprazole(24/66), 60.00% in clozapine (18/30). After 4 weeks of treatment, the serum potassium level was significantly lower than that on the first day after admission [(3.98±0.32)mmol/L vs (4.19±0.33) mmol/L, P<0.01], but it was similar to that after 8 weeks of treatment [(4.16±0.35)mmol/L vs (4.19±0.33)mmol/L, P>0.05]. After 4 weeks of administration, the lowest mean values of serum potassium were caused in turn by clozapine, followed by olanzapine and sulfapiride. Conclusion For schizophrenia patients with low blood potassium, especially the men with a disease duration of less than 5 years and more than 10 years or 18 to 44 years old youth, the attention should be payed to changes in serum potassium concentration within one month of hospitalization and medications that have less influences on blood potassium level to reduce drug response and ensure medical safety.
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基金项目:河北省卫生健康委员会重点科技研究计划项目(20191523)
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