Background: The QT interval shortens in response to sympathetic stimulation. Head-up tilt-table (HUT) testing is a straightforward way to achieve brisk sympathetic stimulation. There is not enough information about the response of the QT interval to HUT, particularly, in patients with orthostatic hypotension (OH). Objective: Analyse the response of the RR, QT and QTc intervals in patients with OH and reflex syncope (NM) during HUT and find differences between groups. Methods: We reviewed the electrocardiograms and compare the RR and QT/QTc intervals during 1) baseline;2) HUT plus hyperventilation;3) positive test. Results: We studied 137 patients, 62 control group (no syncope and negative HUT). On average, the RR HUT interval was shorter than the resting RR by −171 ± 110.4 ms in controls;−228.6 ± 119.4 ms (NM) and −194 ± (OH) (P Conclusion: Significant differences between the reflex group and the OH during a positive test, the QTc decreased in the NM group, but in the OH population increased. This observation has not been described. We hypothesize that QTc prolongation could reflect autonomic nervous system downregulation and could explain to a degree, the increased mortality in this group.
目的观察氨磺必利与齐拉西酮治疗精神分裂症的临床疗效及对心电图QTC间期的影响。方法选取2020年5月至2022年8月吉安市第三人民医院收治的76例精神分裂症患者作为研究对象,采用随机数字表法分为常规组与研究组,各38例。常规组服用盐酸齐拉西酮胶囊,研究组服用氨磺必利。比较两组临床疗效、阳性和阴性症状量表(positive and negative syndrome scale,PANSS)评分、记忆功能[韦氏记忆量表中国修订版(Wechsler memory scale-revised Chinese version,WMS-RC)评分]、认知功能[简易智能精神状态检查量表(mini-mental state examination,MMSE)评分]、QTC间期及不良反应发生情况。结果两组治疗总有效率比较差异无统计学意义。用药后,两组一般精神病理、阳性症状、阴性症状评分及总分均低于用药前,差异有统计学意义(P<0.05),但组间比较差异无统计学意义。用药后,两组WMS-RC、MMSE评分均高于用药前,差异有统计学意义(P<0.05),但组间比较差异无统计学意义。用药后2、4、8周,研究组QTC间期均短于常规组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论氨磺必利、齐拉西酮治疗精神分裂症临床疗效及安全性相当,均可减轻患者阳性及阴性症状,改善患者记忆功能与认知功能,但氨磺必利对心电图QTC间期的影响更小,值得临床推广应用。
