精神分裂症与代谢综合征的患病率、危险因素及护理管理

目的调查精神分裂症患者代谢综合征的患病率及危险因素,探讨预防和控制代谢综合征的护理管理措施。方法 503名住院精神分裂症患者和60名健康自愿者接受调查,收集人口学资料和病史资料,测量相关生理和生化指标,按IDF标准诊断代谢综合征(M S)。结果精神分裂症患者M S的患病率为28.4%,显著高于对照组(χ2=24.275,P=0.000),女性患者患病率(39.8%)高于男性(22.3%)(χ2=17.120,P=0.000),40岁以上患者的患病率(30.9%)高于39岁以下患者(22.1%)(χ2=3.421,P=0.064);血脂异常(TG增高和HDL-C降低)、肥胖(BM I和腰围)和血糖增高是最重要的危险因素(OR值>6.0),总胆固醇增高、血压增加、LDL-C增高、尿酸增高、女性、在婚和偏执型也是重要的危险因素(OR值>2.0),年龄、教育、首发年龄和蛋白质等也有一定影响。结论精神分裂症患者具有较高M S患病率,血脂异常、肥胖和血糖增高是最重要的危险因素和预测指标。护理管理可以在M S的预防、早期识别和疾病控制中发挥重要作用。

The Schizophrenia and Metabolic Syndrome:Prevalence,Risk Factors and Nursing Management

Objective To investigate prevalence of metabolic syndrome(MS) and risk factors in patients with schizophrenia,and explore nursing management in preventing and controlling the MS.Methods A total of 503 inpatients with schizophrenia and 60 healthy volunteers were included in this study.The demographic information and medical data of these participants were recorded,and their physiological and biochemical parameters were measured,the MS was diagnosed according to IDF criteria.Results The MS prevalence in patients with schizophrenia was 28.4%,which was significantly higher than that of control group(χ2=24.275,P=0.000);the prevalence of MS was higher among female patients(39.8%) than male patients(22.4%)(χ2=17.120,P=0.000);the prevalence of MS was higher among patients aged 40 or over(30.9%) than patients aged 40 below(22.1%)(χ2=3.421,P=0.064).Dyslipidaemia(elevated TG and reduced HDL-C),and obesity(BMI and waist) and increased blood glucose were the most important risk factors(OR value >6.0),increased total cholesterol,high blood pressure,elevated LDL-C,increased uric acid,female,in marriage,and paranoid type were also important risk factors(OR value >2.0),older age,low education,and later onset,and high protein had effect.Conclusion There are higher MS prevalence in patients with schizophrenia.Dyslipidemia,obesity and elevated blood glucose are the most important risk factors and predictors of the MS.Nursing management can play important role in the prevention,early detection,and controlling of the MS.