长期服用抗精神病药物对慢性精神分裂症患者颈动脉粥样硬化影响的多因素分析

目的探讨长期服用抗精神病药物慢性精神分裂症患者颈动脉粥样硬化状况及其影响因素.方法对89例住院治疗的慢性精神分裂症患者统计临床资料,并进行肝脏和颈动脉超声检查,同时检测血清谷丙转氨酶、谷草转氨酶、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白水平,根据检测结果进行对比分析及逐步多元回归分析.结果本组89例患者中颈动脉粥样硬化病变检出率为27.0%,肝脏脂肪变检出率为33.7%;肝脏脂肪变患者颈动脉粥样硬化病变检出率(40.0%)显著高于无肝脏脂肪变患者(20.3%)(P<0.05);颈动脉超声检查正常组年龄显著小于颈动脉粥样硬化病变组(P<0.01),血清高密度脂蛋白水平显著高于颈动脉粥样硬化病变组(P<0.05);逐步多元回归分析显示年龄偏大、共患糖尿病、血清低密度脂蛋白与颈动脉粥样硬化病变呈显著正相关(P<0.05或0.01),血清高密度脂蛋白与颈动脉粥样硬化病变呈显著负相关(P<0.05).结论长期服用抗精神药物慢性精神分裂症患者颈动脉粥样硬化病变发生率较高,可能与患者年龄偏大、血糖升高或高血压、血脂异常等因素相关.

Analysis of long-term use of antipsychotic drugs on cervical atherosclerosis in patients with chronic schizophrenia and its influencing factors

Objective To investigate the long term use of antipsychotic drugs on cervical atherosclerosis in patients with chronic schizophrenia and its influencing factors.Methods Clinical data of 89 patients with chronic schizophrenia was analyzed.Liver and carot id ultrasonography was performed.The levels of serum alanine aminotransferase,aspartate aminotransferase,total cholesterol,triacylglycerol,high density lipoprotein,low density lipoprotein were detected.Comparative analysis and stepwise multiple regression analysis were performed based on the test results.Results In this group of 89 patients,the detection rate of CAS was 27.0%,and the detection rate of liver steatosis was 33.7%.The detection rate of CAS in liver steatosis group(40.0%)was significantly higher than that in liver steatosis group(20.3%)(P<0.05).The age of the normal group of carotid ultrasound was significantly smaller than that of the carotid atherosclerotic lesion group(P<0.01),and the serum HDL level was significantly higher than that of the CAS group(P<0.05).Stepwise multiple regression analysis showed that there was a significant positive correlation between age,co-diabetes,serum LDL and CAS(P<0.05 or0.01).There was a negative correlation between serum HDL and CAS(P<0.05).Conclusions Patients with chronic schizophrenia who take antipsychotic drugs for a long time have a higher incidence of carotid atherosclerotic lesions,which may be related to patients'higher age,elevated blood sugar or hypertension,and abnormal blood lipids.