503例住院精神分裂症患者共患糖尿病的调查

目的：调查住院精神分裂症患者糖尿病的发生情况及相关因素。方法：对503例住院精神分裂症患者进行病历资料回顾，体格检查及血生化检测。结果：住院精神分裂症患者糖尿病的时点患病率为12．9％，显著高于一般人群的3．21％（OR=4．48，CI=3．43～5．84，P〈0．01）。40—49岁的患者中糖尿病患病率增高明显（14．6％vs．3．02％，OR=5．51，CI=3．49～8．70，P〈0．01）。糖尿病发生与年龄、体质量超重及腹型肥胖有关。糖尿病组患者的病程比非糖尿病患者长（Z=-6．989，P〈0．01），接受目前抗精神病药物治疗时间也比非糖尿病患者长（Z=-4．794，P〈0．01）。氯氮平新发糖尿病患病率高于利培酮组与经典药物组（P〈0．01），利培酮组与经典药物组患病率差异无统计学意义（P〉0．05）。结论：住院精神分裂症患者糖尿病患病率高于一般人群，与患者年龄、体质量超重、病程及抗精神病药治疗时间有关。氯氮平比利培酮及经典药物可能更容易导致糖尿病的发生。

Prevalence of diabetes mellitus in 503 schizophrenic inpatients

Objective： To investigate the prevalence rate of diabetes mellitus and risk factors among schizophrenic inpatients. Method：In 503 schizophrenic inpatients,the personal history,family history and treatment history were collected according to medical records. Meanwhile, a thorough physical examination and fast blood glucose testing were done. Results：The overall prevalence rate of type 2 diabetes mellitus was 12.9% ,which is significantly higher than the prevalence of 3.21% in the general population （ OR = 4.48, CI = 3.43 - 5.84, P 〈 0. 01 ）. The prevalence rate increased significantly in patients aged 40 - 49（ 14.6% vs. 3.02%, OR = 5.51, CI = 3.49 - 8.70, P 〈 0. 01 ）. The increased prevalence was found to be related to age, overweight and abdominal obesity. There was significant difference of duration of illness and the time of exposure to current antipsyehotie treatment between the diabetic subjects and non-diabetic subjects （ Z = - 6.989, P 〈 0. 01, and Z = - 4. 794, P 〈 0. 01, respectively）. Subjects receiving elozapine treament exhibited higher prevalence of new-onset diabetes mellitus compared with subjects receiving risperidone or typical antipsychotics （ P 〈 0. 01 ）, whereas subjects receiving risperidone treament not, compared with typical antipsychotics （ P 〉 0. 05 ）. Conclusion： The prevalence rate of type 2 diabetes mellitas in schizophrenic inpatients is signifieandy higher than in the general population. The prevalence rate of type 2 diabetes mellitus is found to be related to age, overweight, abdominal obesity, duration of illness and the time of exposure to antipsyehotie treatment. Clozapine is associated with high rates of diabetes mellitus than risperidone and typical antipsychotics.