男性精神分裂症患者骨密度降低的危险因素研究及OSTA指数的预测价值  

The risk factors of low bone mineral density in male inpatients with schizophrenia and the prediction value of OSTA index

作　　者：袁菁[1] 邹凯[1] 刘晓伟[1] 易峰[1] 赵幸福[1] 

机构地区：[1]南京医科大学附属无锡市精神卫生中心,江苏无锡214151

出　　处：《中国医药导报》2016年第24期97-100,共4页China Medical Herald

摘　　要：目的探讨男性精神分裂症患者骨密度降低的危险因素，并评价亚洲人骨质疏松自我筛查工具（OSTA）在男性精神分裂症患者中的应用价值。方法以2014年4月～2015年12月在无锡市精神卫生中心住院并符合CCMD-3诊断标准的149例男性精神分裂症患者作为研究对象。使用ALOKA超声波干式骨密度仪器监测149例男性精神分裂症患者右足后跟的骨密度T值，以T值〈-2．5为骨质疏松、T值〈-1为低骨量。将OSTA指数与骨密度T值相比较，来评价其在骨质疏松和低骨量中的筛查价值。应用Logistic回归，对149例男性精神分裂症患者发生低骨量的危险因素进行筛查，并评估其模型的诊断价值。结果T值〈-2．5时，OSTA指数受试者工作特征曲线下面积（AUC）为0．619（95％CI：0．426～0．811）；T值〈-1时，OSTA指数AUC为0．531（95％CI：0．422～0．641）。Logistic回归共筛选出3项差异有统计学意义的指标：BMI、高脂血症、泌乳素升高（P〈0．05），其OR值分别为0．819、2．810、4．381。综合预测模型的灵敏度、特异度分别为79．3％和64．3％。结论OSTA对男性精神分裂症患者骨质疏松症和低骨量的筛查价值较低。BMI是精神分裂症患者骨密度减少的保护因素，而高脂血症和泌乳素升高都是骨密度下降的危险因素。Objective To explore the risk factors of low bone mineral density （BMD） in male inpatients with schizophrenia, and assess the prediction value of osteoporosis self-assessment tool for Asians （OSTA）. Methods 149 male inpatients in Wuxi Mental Health Center Affiliated to Nanjing Medical University from April 2014 to December 2015 met with the diagnostic criteria of schizophrenia according to CCMI）-3 were enrolled. The T-score of the right calcaneal BMD was measured in all patients by ALOKA ultrasonic bone density apparatus, accordingly subjects were divided into osteoporosis （OP） group （T〈-2.5）, low BMD group （T〈-I） and normal group （T≥-1）. OSTA index and BMD T-score was compared, in order to evaluate the screening value of OSTA index in OP and low BMD patients. Logistic regression was used to explore the risk factors for low BMD, and the diagnostic value of the model was evaluated. Results Accord, ing to the T-scores, the area under the curve （AUC） of OSTA index for detecting OP was 0.619 （95%CI： 0.426-0.811） and that for detecting low BMD was 0.531 （95%CI： 0.422-0.641）. Three factors were found to had significant effect on low BMD （P 〈 0.05）, that was, BMI （OR=0.819）, hyperlipemia （OR=2.810） and hyper-prolactin （OR=4.381）. The sensitivity and specificity of the comprehensive prediction model were 79.3% and 64.3%, respectively, Conclusion Hyperlipemia and hyper-prolactin are risk factors, while BMI is a protective factor, for low BMD in male inpatients with schizophrenia. OSTA index exhibits a low predictive value for detecting OP and low BMD in those people.

关 键 词：精神分裂症 泌乳素 高脂血症 骨密度 

分 类 号：R749.3[医药卫生—神经病学与精神病学]