精神分裂症患者发生代谢综合征危险因素研究

目的 探讨精神分裂症患者代谢综合征发生的危险因素,方法 以是否发生代谢综合征为标准,将84例单一服用氯氮平治疗的精神分裂症患者分为两组,其中代谢综合征组36例,非代谢综合征组48例.收集患者的一般资料,包括性别,年龄,吸烟史,教育程度,婚姻状况,服药剂量,服药时间,晨起空腹状态下测定患者的体重,身高,腰围,血压,空腹血糖,总胆固醇,甘油三酯,低密度脂蛋白,高密度脂蛋白,C-反应蛋白,IL-6,比较分析两组一般资料和所测定指标的差异.结果 代谢综合征组患者的吸烟率(P=0.006),腰围(P=0.001),空腹血糖(P＜0.001),甘油三酯(P=0.008),C-反应蛋白(P＜0.001)和白介素-6 (P＜0.001)水平明显高于非代谢综合征组,两组间差异具有统计学意义.以是否发生代谢综合征为因变量,建立Logistic回归模型,血糖(95％ CI,OR:5.5,27.03),收缩压(95％CI,OR:1.84,2.39),年龄(95％ CI,OR:1.17,1.37),腰围(95％ CI,OR:1.83,3.07),甘油三酯(95％ CI,OR:23.08,45.26),C-反应蛋白(95％ CI,OR:1.08,2.94)这6个变量进入回归方程.结论 发生代谢综合征的精神分裂症患者,具有更高的吸烟比率,腰围,空腹血糖,甘油三酯和C-反应蛋白水平,而空腹血糖,收缩压,年龄,腰围,甘油三酯和C-反应蛋白是代谢综合征发生的独立危险因素,可以作为预测指标,做到代谢综合征的早期预防和干预.

The risk factors for schizophrenia patients to develop metabolic syndrome

Objective The purpose of this study was to explore the risk factors of metabolism syndrome in schizophrenia. Methods 84 schizophrenic patients treated with clozapine were divided to two groups ,one with metabolism syndrome （ n = 36）, the other without metabolism syndrome （ n = 48）. The demographic data,including sex, age, smoking history, education level, marriages, dose of clozapine, duration of drug administration were collected. The body weight, height, waist circumference, fasting glucose,total cholesterol,blood pressure, triglyceride,low density lipoprotein, high density lipoprotein,C- reactive protein,interleukin 6 were measured and compared between the two groups. Results Patients with metabolism syndrome tend to have higher level of smoking rate（P = 0.006）, waist circumference （P = 0. 001）, fasting glucose （P 〈0. 001）, serum triglyceride （P = 0. 008）, C-reactive protein （P 〈 0. 001） and interleukin 6 （P〈 0. 001） than those without metabolic syndrome. The logistic analysis was performed to explore the risk factors for metabolism syndrome and the results showed that fasting glucose （95% CI OR ： 5.5,27.03） ,systolic pressure（ OR 95% CI .. 1.84,2.39） ,age（95%CI OR .. 1.17,1.37）, waist circumference （ OR 95 % CI ： 1.83 , 3.07）, serum triglyceride （95 % CI OR ： 23.08, 45.26）,C-reactive protein（ OR 95 % CI： 1.08,2.94） turned to be the independent risk factors for metabolism syndrome. Conclusions Schizophrenic patients with metabolism syndrome had higher level of smoking rate , waist circumference, fasting glucose,diastolic pressure and C-reactive protein. These parameters could be used as predictors for metabolism syndrome in schizophrenic patients, so that early clinical prevention and intervention could be performed.