氯氮平治疗精神分裂症引发代谢综合征危险因素研究

目的 探讨氯氮平治疗的精神分裂症患者发生代谢综合征（metabolic syndrome,MS）的危险因素.方法 入组单一使用氯氮平治疗的精神分裂症患者108例,收集患者的年龄、性别、吸烟情况、代谢疾病家族史、服药时间、服药剂量、体质量指数（BMI）、腰围、血压、阳性和阴性综合征量表（PANSS）评分、空腹血糖、甘油三酯（TG）、胆固醇（TC）、高密度脂蛋白、低密度脂蛋白.以是否发生MS分为两组,分析组间代谢相关因素的差异,并进行Logostic回归分析.结果 MS组的腰围、TG、空腹血糖、收缩压、舒张压高于非MS组（P＜0.05）;MS组的年龄、吸烟史、TC、服用氯氮平时间、BMI高于非MS组（P＜0.05）.而MS组的PANSS量表总分低于非MS组（P＜0.05）;经Logistic回归分析筛选,年龄（P=0.008）、腰围（P =0.002）及PANSS总分（P=0.011）进入回归方程.结论 氯氮平治疗发生MS的精神分裂症患者,具有更高的年龄、吸烟比率、腰围、服药时间、BMI、空腹血糖、血压、甘油三酯及胆固醇水平,但精神症状评分较低.发生MS的独立危险因素为：高龄、腰围增加、精神症状评分较轻.

Risk factors of metabolic syndrome in schizophrenic patients treated with clozapine

Objective To explore the risk factors of metabolic syndrome （MS） in schizophrenic patients treated with clozapine.Methods 108 schizophrenic patients treated with clozapine monotherapy were investigated to obtain their clinical informations,which included age,gender,smoking status,family history of MS,course of clozapine treatment,dosage of clozapine,body mass index （BMI）,waist circumference,blood pressure,score of Positive and Negative Syndrome Scale （PANSS）,fasting blood glucose,level of total cholesterol,level of triglycerides,level of high-density lipoprotein （HDL） and low-density lipoprotein （LDL）.All patients were divided into MS group and non-MS group according to the diagnostic criteria of MS.All the variables associated with MS were compared between the two groups and then were analysed by using logistic regression analysis.Results Waist circumference,systolic pressure,diastolic pressure,level of fasting blood glucose and triglycerides in MS group were significantly higher than those in non-MS group （P ＜ 0.05）.Age,smoking status,level of total cholesterol,course of clozapine treatment,BMI in MS group were significantly higher than those in non-MS group （P ＜ 0.05）.Score of PANSS in MS group was significantly lower than that in non-MS group （P ＜ 0.05）.Age （P =0.008）,waist circumference （P =0.002） and score of PANSS （P =0.011） entered the logistic regression equation.Conclusion Schizophrenic patients with MS resulted from clozapine treatment tend to have advanced age,high smoking rate,increased waist circumference,long course of clozapine treatment,high BMI,high blood pressure,high level of fasting blood glucose,high cholesterol,high triglyceride,but low score of PANSS.The independent risk factors of MS in schizophrenic patients consist of advanced age,increased waist circumference and low score of PANSS.