住院精神病患者罹患高脂血症相关因素调查

目的 了解住院精神病患者罹患高脂血症的相关因素,为临床干预提供依据.方法 对452例住院精神病患者进行调查,统计一般人口学资料及药物治疗状况,检测空腹血糖及血脂水平,测量血压,评估代谢综合征危险因素,对代谢综合征危险因素不同个数患者的血脂代谢指标检测结果进行对比分析.结果 本组高脂血症检出率高达43.1%,其中高三酰甘油血症16.9%,高胆固醇血症12.3%,低高密度脂蛋白血症67.7%,混合型高脂血症3.1%;仅29.2%高脂血症患者予以低脂饮食及口服非诺贝特调脂治疗.高脂血症检出率男性患者显著高于女性(χ2=14.110,P＜0.01),有糖尿病史者显著高于无糖尿病史者(χ2=11.852,P＜0.01),住院时间≥84 d者显著高于＜84 d者(χ2=8.430,P＜0.01).患者随着代谢综合征危险因素的增多,血清三酰甘油、低密度脂蛋白逐渐升高,高密度脂蛋白逐渐下降(F=17.635、3.891、8.831,P＜0.01);Logistic分析发现,男性、既往有糖尿病史、三酰甘油＞1.7 mmol·L-1等为精神病患者罹患高脂血症的危险因素(B=-1.334、0.964、1.551,P＜0.05或0.01).结论 精神病患者高脂血症发生率高,影响因素较多,但临床医生对高脂血症的关注较少,实施调脂治疗率较低,此问题应引起临床医生的重视.

Surveys of relative factors causing hyperlipidemia among hospitalized mental patients

Objective To investigate relative factors causing hyperlipidemia among hospitalized mental pa tients in order to provide basis for clinical intervention. Methods Investigations were carried out in 452 hospitalized mental patients, general demography data and medication status were added up, blood-fasting sugar and blood fat detected, BP measured, metabolic syndrome risk factors assessed, detection results of blood fat metabolism index eontrastively analyzed among patients with different metabolic syndrome risk factors. Results The detection rate of hyperlipidemia reached up to 43.1%, among them hypertriacylglyc erolemia 16.9%, hypercholesterolemia 12.3%, low HDL-C 67.7% and combined hyperlipidemia 3. 1%; Only 29.23% patients received low fat diet and oral fenofibrate treatment. The detection rate of hyperlipidemia was significantly higher in male than in female patients （X^2 = 14.110, P〈0.01）, in patients with diabetes history than in ones without （X^2 =11. 852,P〈0.01） and in ones whose hospitalization time were 84 days than in ones 〈84 （X^2 =8. 430,P〈0.01）. Along with the increase of metabolic syndrome risk factors, patients＇ serum triacylglycerol and low density lipoprotein heightened gradually and HDL lowered （F=17. 635, 3. 891, 8. 831,P〈0.01）; Logistic analysis showed that male, past diabetes history, triacylglycerol 〉1. 7 mmol ·L^-1 and so on were risk factors causing hyperlipidemia in mental patients （B= -1. 334, 0. 964, 1. 551,P〈0.05 or 0.01）. Conclusion The incidence of hyperlipidemia in patients with mental disorders is high, but clinicians pay less attention to hyperlipidemia and the rate of regulating lipid therapy is lower, and clinicians should pay close attention to this problem.