抗精神病药影响血脂代谢的巢式病例对照研究  

Lipid metabolism in schizophrenic patients with antipsychotics:a nested case-control study

作　　者：谭梅娟[1] 李靖 TAN Mei-juan;LI Jing(Brain Hospital of Hunan Province,Changsha,Hunan 410007;The First Hospital of Changsha,Changsha,Hunan 410005,China)

机构地区：[1]湖南省脑科医院,湖南长沙410007 [2]长沙市第一医院,湖南长沙410005

出　　处：《热带医学杂志》2020年第9期1203-1205,1231,共4页Journal of Tropical Medicine

基　　金：湖南省自然科学基金(2015JJ6084);湖南省卫生计生委科研基金课题(B2015-105)。

摘　　要：目的探讨抗精神病药对首发精神分裂症住院患者发生高脂血症的影响及其危险因素。方法应用巢式病例对照研究方法,对首发精神分裂症住院患者队列随访1年,队列中新高脂血症病例作为病例组;从该队列中随机抽取未发生高脂血症者作为对照组。对有关暴露因素进行单因素和多因素非条件Logistic回归分析。结果病例组年龄高于对照组,且差异有统计学意义(P<0.05)。多因素分析表明,除年龄外,高脂饮食(OR=6.413,95%CI:2.018~20.373)、单用第二代抗精神病药物(SGA)(OR=29.337,95%CI:7.371~116.756)治疗、第一代抗精神病药物(FGA)和SGA联合用药(OR=14.459,95%CI:3.181~65.728)治疗均为首发精神分裂症住院患者发生高脂血症的危险因素。首发精神分裂症住院患者联合用药组(FGA+SGA)心律失常的发生率虽高于FGA组和SGA组,但差异无统计学意义(P>0.05)。将调查资料重新整理,首发精神分裂症患者心律失常的发生率为9.65%。联合用药组(FGA+SGA)心律失常的发生率为12.50%,高于FGA组的10.14%和SGA组的6.90%,但差异无统计学意义(x2=0.421,P>0.05)。结论单用第二代抗精神病药物治疗及联合用药治疗可引发首发精神分裂症住院患者发生高脂血症。Objective To explore the risk factors and the effect of antipsychotics on lipid metabolism in inpatients with firstepisode schizophrenia.Methods A nested case-control study was conducted and the cohort of first-episode schizophrenia inpatients was followed for one year.The new hyperlipidemia cases in the cohort were the case group;the nonhyperlipidemia patients were randomly selected from the cohort as controls.Univariate analysis and multivariate nonconditional logistic regression were used to analyze the association factors.Results The age of the case group was higher than that of the control group,and the difference was statistically significant.Multivariate analysis showed that high-fat diet(OR=6.413,95%CI:2.018-20.373),second generation antipsychotic alone(OR=29.337,95%CI:7.371-116.756) and combined use(OR=14.459,95% CI:3.181-65.728) were risk factors for hyperlipidemia in inpatients with first-episode schizophrenia.The incidence of arrhythmia in patients with first-episode schizophrenia was 9.65%.The incidence of arrhythmias in the group with combined use was 12.50%,and higher than that in other two groups,but there was no significant difference(χ~2=0.421,P>0.05).Conclusion The second generation antipsychotic therapy alone and combined therapy could induce hyperlipidemia in first-episode schizophrenic inpatients.

关 键 词：抗精神病药 血脂代谢 首发精神分裂症 巢式病例对照研究 

分 类 号：R749.3[医药卫生—神经病学与精神病学]