中国药物警戒 ›› 2026, Vol. 23 ›› Issue (8): 926-930.
DOI: 10.19803/j.1672-8629.20250580

• 安全与合理用药 • 上一篇    下一篇

氨磺必利致窦性心动过缓影响因素分析

朱利芳, 王领军, 李焕芬, 陈永新, 黄素培, 王金宝, 郭飞*   

  1. 河南医药大学第二附属医院药学部,河南 新乡 453002
  • 收稿日期:2025-08-19 出版日期:2026-08-15 发布日期:2026-08-17
  • 通讯作者: *郭飞,男,硕士,主管药师,精神药理学与医院药学。E-mail: guofei5821@126.com
  • 作者简介:朱利芳,女,硕士,主管药师,临床药学与医院药学。
  • 基金资助:
    河南省医学科技公关计划联合共建项目（LHGJ20220639）

Contributors to sinus bradycardia caused by amisulpride

Zhu Lifang, Wang Lingjun, Li Huanfen, Chen Yongxin, Huang Supei, Wang Jinbao, Guo Fei*   

  1. Department of Pharmacy, the Second Affiliated Hospital of Henan Medical University, Xinxiang Henan 453002, China
  • Received:2025-08-19 Online:2026-08-15 Published:2026-08-17

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摘要： 目的 探讨氨磺必利致窦性心动过缓的发生率及影响因素,为临床合理用药提供参考。方法 利用医院信息系统查阅河南医药大学第二附属医院2024年1月15日至2025年1月15日服用氨磺必利的住院患者病历,考察性别、年龄、BMI、病史年限、服药日剂量、合并用药、基础心率、基线血钾水平等对氨磺必利致窦性心动过缓的影响,并统计窦性心动过缓发生率以及发生时的用药剂量。采用单因素方差分析和多因素Logistic回归进行影响因素分析。结果 共纳入215例患者,72例出现窦性心动过缓,发生率为33.49%,其中16例窦性心动过缓伴心律不齐。根据诺氏评估量表,与氨磺必利很可能有关的15例,可能有关的57例。发生窦性心动过缓时用药剂量≥800 mg·d-1为39例,400~800 mg·d-1为24例,≤400 mg·d-1为9例。单因素分析发现,基础心率、合并用药种类数、合并氯氮平组间比较,差异均具有统计学意义（P<0.05）。多因素分析发现,基础心率、合并氯氮平与氨磺必利致窦性心动过缓均存在显著相关性（P<0.05）。结论 基础心率、合并氯氮平是影响氨磺必利致窦性心动过缓的独立因素。高剂量氨磺必利更容易引起窦性心动过缓,在使用氨磺必利前应对患者进行心电图检查,若患者基础心率较慢,可选择其他抗精神病药。若必须使用,应注意监测患者的心电图,根据心电图的变化及时调整药物剂量或者种类,保证患者用药安全有效。

关键词: 氨磺必利, 氯氮平, 窦性心动过缓, 发生率, 影响因素, 基础心率

Abstract: Objective To explore the incidence and determinants of sinus bradycardia caused by amisulpride and provide a reference for rational medication. Methods The medical records of inpatients taking amisulpride between January 15, 2024 and January 15, 2025 were retrieved from the hospital information system. The effects of gender, age, BMI, medical history, daily dose, concomitant medications, basal heart rate and baseline blood potassium levels on the occurrence of sinus bradycardia were investigated. At the same time, the incidence and the dosage when sinus bradycardia occurred were calculated. Single factor analysis and multivariate logistic regression were used to analyze the contributors. Results A total of 215 inpatients were included in this study, 72 of whom had sinus bradycardia, and 16 were complicated with arrhythmia, so the incidence rate was 33.49%. According to the Naranjo scale, 15 of these cases were probably related to amisulpride and 57 were possibly related. Thirty-nine of these patients were treated with amisulpride at doses of over 800 mg·d-1, 24 at doses that ranged from 400 mg·d-1 and 800 mg·d-1, and 9 at doses of less than 400 mg·d-1. Single factor analysis showed that there were statistically significant differences in basal heart rate, types of combined drugs and combinations with clozapine (all P<0.05). The results of multiple logistic regression analysis suggested that basal heart rate and clozapine were significantly associated with sinus bradycardia caused by amisulpride (all P<0.05). Conclusion Patients should undergo electrocardiogram examinations before using amisulpride. High doses of amisulpride are more likely to cause sinus bradycardia. In case of slow basal heart rate, patients ought to be given other antipsychotic drugs. The dose or type of drugs should be adjusted along with changes in the electrocardiogram to ensure safe and effective medication.

Key words: Amisulpride, Clozapine, Sinus Bradycardia, Incidence, Contributors, Basal Heart Rate

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