影响门诊精神分裂症首次发病患者随访一年疗效的相关因素研究  

A correlative analysis of factors related to therapeutic effect of first-episode schizophrenia

作　　者：沈晓玲[1] 江开达[1] 张红霞[2] 杨晓敏[1] 张怀惠[3] 

机构地区：[1]上海交通大学附属医学院精神卫生中心,200030 [2]复旦大学附属中山医院 [3]上海市杨浦区精神卫生中心精神科

出　　处：《中华精神科杂志》2009年第1期21-24,共4页Chinese Journal of Psychiatry

基　　金：上海市精神疾病临床医学中心科研基金资助项目（K-001-01）

摘　　要：目的探讨影响精神分裂症首次发病（以下简称首发）患者疗效和复发的相关因素。方法采用前瞻性队列研究，结合全病程管理模式，对453例符合国际疾病分类第10版精神分裂症和分裂样精神障碍诊断标准、基线阳性和阴性症状量表（PANss）总分≥60分、病程≤5年的患者，进行1年随访，对13项相关因素与近期疗效及复发情况进行单因素分析，并采用spearman相关分析和t检验。结果PANss总分减分率与性别（r=0．083）、病程（r=-0．228）、起病形式（r=-0．180）、发病诱因（r=0．080）、持续用药时间（r=0．153）存在相关关系（P〈0．05～0．01）；疾病复发与性别（r=-0．131）、持续用药时间（r=0．131）亦存在相关关系（P〈0．01）。结论女性、病程短、起病形式急、病前有诱因、持续用药时间长的精神分裂症首发患者1年的疗效相对好；男性患者及持续用药时间短的患者易复发。Objective The study aimed to explore the main factors related to the effectiveness and relapse for first-episode schizophrenia. Methods It was a one year follow-up prospective cohort study with integrated case management. Four hundred and fifty-three patients, with less than 5-year course of disease, were included who met ICD-10 criteria for schizophrenia （88%） or schizophreniform disorder （ 12% ） and the baseline PANSS scores ≥ 60. Relations between 13 index in the self-made log scale and the reduction rate of total score of PANSS or relapse were analyzed. Spearman＇s bivariate correlation analysis and t test were adopted. Results Pattern of episode, with or without inducement, gender and time form illness were factors significantly related to reduction rate of PANSS score （r = -0. 180, P 〈 0. 01; r = 0. 080, P = 0.045; r = 0.083, P = 0.032; r = -- 0.228, P 〈 0.01, respectively） .Gender and the time to discontinuation were the factors significantly related to relapse or not （ r = - 0. 131, P = 0. 005, r =0. 131, P = 0. 003, respectively）. Conclusions For first-episode schizophrenia, patients with acute pattern of episode, with inducement, with short time form illness, of female and of long time to discontinuation have relatively higher reduction rate of PANSS score, and patients of males and with short time to discontinuation are relatively liable to relapse.

关 键 词：精神分裂症 治疗结果 因素分析 统计学 

分 类 号：R686[医药卫生—骨科学]