非典型抗精神病药对精神分裂症患者脂代谢、骨转换生化指标的影响及路径分析  

Effect of dyslipidemia caused by atypical antipsychotics on bone turnover markers in patients with schizophrenia

作　　者：谢莉 梁凌云 张蓓蓓 XIE Li;LIANG Ling-yun;ZHANG Bei-bei(Brain Hospital of Hunan Province,Changsha 410007,China)

机构地区：[1]湖南省脑科医院(湖南省第二人民医院),长沙410007

出　　处：《临床精神医学杂志》2022年第2期111-113,共3页Journal of Clinical Psychiatry

摘　　要：目的:探讨非典型抗精神病药对精神分裂症患者脂代谢、骨转换生化指标的影响及路径分析。方法:对采用利培酮或奥氮平单药治疗>6个月的精神分裂症患者(病例组,90例)进行血脂[总胆固醇(CHOL)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]及骨转换生化指标血清骨钙素(BGP)和β胶原特殊序列(β-CROSSL)水平检测,结果与90名健康对照者(对照组)比较;采用AMOS17.0软件进行脂代谢对骨转换生化指标影响的路径分析。结果:病例组血清TG、LDL、BGP和β-CROSSL水平明显高于对照组,HDL水平低于对照组(P<0.05或P<0.01);药物、脂代谢和骨转换生化指标的路径分析模型拟合指数(χ^(2)/df)=0.99,P>0.05,显示药物对患者的脂代谢有正向直接影响,对骨转换生化指标有正向直接影响,血清LDL水平对骨转换生化指标有正向直接影响。结论:长期服用非典型抗精神病药的精神分裂症患者血清LDL水平异常,可能作为中介变量调节药物对骨转换生化指标的影响。Objective:To explore the role of lipid as a moderator of atypical antipsychotics on bone turnover markers in patients with schizophrenia.Method:A total of 180 schizophrenic patients aged 18-40 years old were included in the study.The dose and medication time were collected and triglyceride(TG),cholesterol(CHOL),high density lipoprotein(HDL),low density lipoprotein(LDL),osteocalcin(BGP),β-CROSSL were measured.AMOS17.0 software was used to conduct the path analyses.Results:The patients showed higher TG,LDL,BGP andβ-CROSSL and lower HDL than normal people.The model fitness of path analysis among drug,lipids and bone turnover markers was:χ^(2)/df=0.99,P>0.05.The result indicated that the lipid mediated the relationship between atypical antipsychotics and bone turnover markers.Total effect was-0.249(P<0.01),indirect effect was-0.055(P<0.05),direct effect was-0.32(P<0.05).Conclusion:Dyslipidemia caused by atypical antipsychotics as mediated variable mediates the relationship between antipsychotics and bone turnover markers.

关 键 词：抗精神病药 血脂异常 骨转换生化指标 路径分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学]