精神分裂症与糖尿病关系的探讨

目的：了解住院精神分裂症患者中糖尿病的发病情况及其与抗精神病药等因素的关系。方法：回顾性调查符合CCMD－2－R诊断标准的住院精神分裂症患者中的糖尿病发病情况以及抗精神病药的使用情况等相关因素，观察体重、血糖和血脂的变化。糖尿病的诊断按照 WHO关于糖尿病的诊断标准（1980年）作出。将精神分裂症患者中的糖尿病发生率与一般人群中的患病率进行比较，并分析影响糖尿病发生的相关因素。结果：在503例精神分裂症住院患者中，糖尿病的发生率为15．1％，为普通人群（2．5％）的6倍（x^2＝18．10，P＜0．01）。抗精神病药物可引起体重的显著增加(t＝5．45，P＜0．01）。糖尿病的发生与精神分裂症的持续病程、长期住院、患者的年龄以及阳性糖尿病家族史等因素有关。氯氮平对糖尿病的影响与其他抗精神药物无显著差异（x^2＝0．38，P＞0．05）。结论：精神分裂症患者中糖尿病的发生率远高于普通人群，抗精神病药物引起的体重增加可能与此有关，临床上应予以关注。

The relationship between schizophrenia and comobid diabetes mellitus

Objectives: To explore the prevalence and risk factors of diabetes mellitus among the hospitalized patients with schizophrenia. Method: The data of diabetes mellitus (DM) were retrospectively collected in 503 cases of hospitalized schizophrenics and the diagnosis of DM was made according to WHO criteria. The changes of weight, serum glucose and cholesterol were measured during hospitalization. Results: The prevalence of DM in 503 schizophrenic patients was 15. 1% , 6 times of that in general population (2. 5%, P<0. 01). The use of antipsychotics was significantly associated with the weight gain (P< 0. 05). Diabetes mellitus was related to persistent course, long hospitalization, age and the positive family history of DM. Conclusion: The prevalence of DM in this population was much higher than that in general population, and this might be related to the weight gain caused by antipsychotics.