氯氮平致精神分裂症患者心律失常的Meta分析
Arrhythmia induced by clozapine in patients with schizophrenia:a Meta-analysis
陈娅迪 1丁昱 1李倩倩 1刘晓蕾 2王娓娓1
作者信息
- 1. 昆明医科大学第二附属医院,云南 昆明 650033
- 2. 昆明医科大学第一附属医院,云南 昆明 650032
- 折叠
摘要
背景 氯氮平属于非典型抗精神病药物,对精神分裂症有较好的治疗效果,但氯氮平可导致患者出现心律失常.目前,关于氯氮平致心律失常的类型及其不良反应发生率尚缺乏系统性的研究.目的 通过Meta分析探索氯氮平致精神分裂症患者心律失常的类型和发生率,为临床治疗提供参考.方法 于2022年10月31日,计算机检索PubMed、Embase、Cochrane Library、中国知网,收集氯氮平致精神分裂症患者心律失常的相关文献.采用澳大利亚循证卫生保健中心(JBI)对纳入文献进行质量评价.采用Review Manager 5.4进行Meta分析.结果 共纳入12篇文献,包含42 490例服用氯氮平的精神分裂症患者.氯氮平导致心律失常的发生率为23%(95%CI:0.16～0.29),其中,心动过速发生率为25%(95%CI:0.15～0.35),房性心律失常发生率为6%(95%CI:-0.02～0.14),室性心律失常发生率为7%(95%CI:-0.02～0.16),传导阻滞发生率为2%(95%CI:0～0.04),QTc延长发生率为4%(95%CI:-0.04～0.12),T波改变发生率为23%(95%CI:0.16～0.30).结论 精神分裂症患者服用氯氮平后,发生心律失常的风险可能增加,其中心动过速的发生风险最高.
Abstract
Background Clozapine belongs to atypical antipsychotic drugs that has shown significant efficacy in treating schizophrenia.However,clozapine can induce arrhythmias in patients.Currently,there is a lack of systematic research on the types and incidence of clozapine-induced arrhythmias.Objective To explore the types and incidence of arrhythmias in patients with schizophrenia induced by clozapine through Meta-analysis,so as to provide references for clinical treatment.Methods On October 31,2022,a search was conducted through PubMed,Embase,Cochrane Library and China National Knowledge Infrastructure(CNKI)to collect relevant literature on clozapine-induced arrhythmia in patients with schizophrenia.Joanna Briggs Institute(JBI)was used to evaluate the quality of the included literature.Meta-analysis was conducted using Review Manager 5.4.Results A total of 12 studies were included,involving 42 490 schizophrenia patients taking clozapine.The incidence of arrhythmias caused by clozapine was 23％(95％CI:0.16～0.29).Among them,the incidence of tachycardia was 25％(95％CI:0.15～0.35),atrial arrhythmia was 6％(95％CI:-0.02～0.14),ventricular arrhythmia was 7％(95％CI:-0.02～0.16),conduction block was 2％(95％CI:0～0.04),QTc prolongation was 4％(95％CI:-0.04～0.12)and T-wave changes was 23％(95％CI:0.16～0.30).Conclusion Schizophrenia patients taking clozapine may increase their risk of developing arrhythmia,with tachycardia being the most prevalent.
关键词
氯氮平/精神分裂症/心律失常/Meta分析Key words
Clozapine/Schizophrenia/Arrhythmias/Meta-analysis引用本文复制引用
基金项目
国家自然科学基金(82360275)
云南省科技厅科技计划项目(202301AY070001-020)
云南省教育厅科学研究基金项目(2023Y0640)
昆明医科大学研究生创新基金(2023S302)
出版年
2024
国家科技期刊平台
NSTL
万方数据