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Yıl:2012; Cilt: 1; Sayı: 2>> Özet
TAM METİN
NPAkademi; 2012;1(2):17-29
Lityum ve Karbamazepin Kullanan Olgularda Kalp İşlevlerinin Değerlendirilmesi
EE Erşan, S Aslan, O Doğan
Numune Hastanesi, Sivas
Amaç: Bu çalışmada, lityum ve karbamazepinin kalp işlevleri üzerine olan etkilerini belirlemek ve karşılaştırmak, ortaya çıkan bulguların yaygınlığını saptamak ve kardiyolojik açıdan dikkat edilmesi gereken durumları belirlemek amaçlanmıştır. Yöntem: Bu çalışmaya, en az bir yıldır lityum veya karbamazepin kullanan, bilinen kalp hastalığı olmayan, birincil hastalığı açısından remisyonda olan, sistemik ve nörolojik hastalığı olmayan, alkol ve madde bağımlılığı olmayan 31’i lityum ve 17’si karbamazepin kullanan toplam 48 olgu alınmıştır. Bu sayı, psikiyatri anabilim dalına başvuran ve çalışmamız için gerekli koşulları sağlayan tüm olguları içermektedir. Hastaların onayları alındıktan sonra sosyodemografik bilgi formu doldurulmuştur. Lityum grubunda serum lityum düzeylerine bakıldıktan sonra sırasıyla elektrokardiyografi, efor testi, 24 saatlik Holter kaydı, karotis sinüs masajı, atropin testi ve intrinsik kalp hızı testi yapıldı. Bulgular: Lityum kullanan olguların %9.7’sinde t negatifliği saptandı. Efor testinde lityum grubunda %35.5, karbamazepin grubunda %17.6 oranında kronotropik yetersizlik saptandı. İki grupta da karotis sinüs masajı ile asistoli saptanmadı. Atropin testi lityum kullanan olguların %22.6’sında anormal olarak bulunurken, karbamazepin grubunda anormallik saptanmadı. İki grup arasında lityum grubunda daha kötü olmak üzere minimum ve ortalama kalp hızları açısından fark anlamlı bulundu. Egzersiz testinde maksimum kalp hızı ve kronotropik yetersizlik, holter kaydında maksimum kalp hızı, supraventriküler ektopi, ventriküler ektopi ve intrinsik kalp hızları açısından iki grup arasında istatistiksel olarak fark yoktu. Sonuç: Sonuç olarak lityumun kalp işlevleri üzerinde baskılayıcı etkisinin karbamazepinden daha fazla olduğu söylenebilir.
The Effects of Lithium and Carbamazepine to Cardiac Functions
Objective: The aim of this study that determining and comparing the effects of lithium and carbamazepine on cardiac functions node to find out the appearing cases widespread and determining the required conditions related to cardiology. Methods: Forty-eight cases were taken to this study. These cases have been using lithium or carbamazepine for at least one year. They do not have any known heart or systematic or neurologic disorders and on remission in the case of primer disease. These people also do not use alcohol or any other substances. Among these 48 cases, 31 of them have been using lithium and rest (17) of them carbamazepine. This number contains all the events that applied to the psychiatric department and provides the required conditions in which we work. After taking the cases approvals, a sociodemographic form was filled out. In the lithium group, after looking at the serum lithium levels, in orders of electrocardiography, exercise test a 24 hour Holter registration, carotis sinus massage, atropine test and intrinsic heart rate test were done. Results: In the cases that use lithium, 9.7% of t negative has been determined. In the exercise test it has been found out that 35.5% in the lithium group and 17.6% in the carbamazepine group have chronotropic incomepetence. Asistoly was not determined with carotis sinus massage in both of these groups. The atropine test on lithium users was considered abnormal with a ratio of 22.6%, and no abnormality was determined in the carbamazepine group. Between the two groups, especially worse in the lithium group, it has been found out that the difference was meaningful because of the minimum and average heart rate. In the exercise test maximum heart rate and chronotropic incompetence, in holter registration, maximum heart rate, supraventricular ectopy, ventricular ectopy and intrinsic heart rate had been researched and it was seen that there were no statistically differences between these two groups. Conclusion: As a result, it can be said that lithium has a more evident effect on sinus node compared with carbamazepine.

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