未服药精神分裂症患者糖代谢异常分析  

Disorders of glucose metabolism in medication-free patients with schizophrenia

作　　者：陈松[1] 杨贵刚[1] 王志仁[1] 王玥婵[1] 周东丰[2] 李娟[1] 卞清涛[1] 谭云龙[1] 杨甫德[1] 

机构地区：[1]北京回龙观医院,100096 [2]北京大学精神卫生研究所,100191

出　　处：《上海精神医学》2010年第5期275-278,共4页Shanghai Archives of Psychiatry

基　　金：北京市自然科学基金(7092047)

摘　　要：目的探讨未服药精神分裂症患者病理症状与糖代谢异常之间的关系。方法研究共纳入未服用抗精神病药的精神分裂症患者73例(从未治疗者39例,停药>4周者34例),进行葡萄糖耐量试验(OGTT),并检测总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)浓度,测量腰围、臀围,计算腰臀比。采用阳性与阴性症状量表(PANSS)评定患者精神病理症状。结果 73例患者糖代谢异常的构成比为28.8%,其中从未治疗组患者与停药组患者的异常构成比分别为33.3%和23.5%,差异无统计学意义(P>0.05)。回归分析发现年龄(OR=1.069,P=0.015)、阴性分量表总分(OR=1.120,P=0.019)与糖代谢异常的发生呈正相关。结论未经治疗的精神分裂症患者中糖代谢异常的构成比高,属于2型糖尿病的高危人群;在当前无抗精神病药物影响的前提下,高龄和严重的阴性症状可能为精神分裂症患者发生血糖代谢紊乱的危险因素。Objective：Assess the relationship of psychopathological symptoms and glucose metabolism in schizophrenia.Methods：Thirty-nine medication-naive schizophrenic patients and 34 schizophrenic patients who had been medication-free for at least one month were administered the oral glucose tolerance test;their waist-to-hip ratio was measured;their clinical symptoms were evaluated using the Positive and Negative Syndrome Scale（PANSS）;and their bloods were drawn to assess total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,triglycerides,and apolipoprotein A1 and B.Results：The prevalence of dysglycemia in all 73 patients was 28.8%;33.3% for medication-naive patients and 23.5% for patients who had been medication-free for one month,respectively（P〉0.05）.Multivariate logistic regression analysis indicated that dysglycemia was positively associated with age（OR=1.069,P=0.015）and with the score of the negative symptom subscale of PANSS（OR=1.120,P=0.019）.Conclusion：The relatively high rate of abnormal glucose metabolism in drug-naive patients with schizophrenia suggests that schizophrenic patients are at high risk of developing type 2 diabetes mellitus,and that this risk is not related to their medication usage history.Among patients with schizophrenia who are not currently using medication（including medication-naive and medication-free patients）,older age and more severe negative symptoms are predictors of dysglycemia.

关 键 词：精神分裂症 精神病理学 糖代谢异常 

分 类 号：R749.3[医药卫生—神经病学与精神病学]