住院精神分裂症患者营养状态调查及影响因素分析  

Investigation of nutritional status and analysis of influencing factors in hospitalized patients with schizophrenia

作　　者：施莹娟 吴萍[2] 张峻弓 宛京华 谢红涛[1] SHI Yingjuan;WU Ping;ZHANG Jungong(Shanghai Putuo Mental Health Center,Shanghai 200065,China)

机构地区：[1]上海市普陀区精神卫生中心,上海市200065 [2]上海市同济医院

出　　处：《精神医学杂志》2024年第6期573-578,共6页Journal of Psychiatry

基　　金：2021年上海市普陀区卫生健康系统科技创新项目(编号:ptkwws202120)。

摘　　要：目的评估住院精神分裂症(SCZ)患者的营养状态并分析其影响因素。方法收集401例住院SCZ患者人口学资料、病史资料、体格测量指标及多项实验室营养代谢指标。根据控制营养状态(CONUT)评分将住院SCZ患者分为营养状态异常组和营养状态正常组。比较两组一般情况及各营养代谢指标在内的临床资料的差异,分析住院SCZ患者发生异常营养状态的危险因素,并对住院SCZ患者是否出现营养状态异常进行风险预测效能分析。结果营养不良检出率39.40%,其中轻度营养不良33.67%,中度营养不良5.74%,未检出重度营养不良。营养状态异常组男性、年龄、病程、合并躯体疾病均高于营养状态正常组(P<0.05);营养状态异常组体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、血红蛋白(Hb)、白细胞(WBC)、总蛋白(TP)、前白蛋白(PA)、甘油三酯(TG)、高密度脂蛋白胆固醇(LDL-C)、血尿酸(SUA)均低于营养状态正常组(P<0.01)。营养状态异常与年龄、病程、合并躯体疾病均呈正相关(P<0.001);与男性、BMI、SBP、DBP、Hb、WBC、TP、PA、TG、LDL-C、SUA均呈负相关(P<0.05)。男性、合并躯体疾病、BMI低、Hb低、WBC低、PA低、LDL-C低是引起营养状态异常的危险因素(P<0.05)。LDL-C、Hb、PA、BMI、WBC、合并躯体疾病对住院SCZ患者发生营养状态异常有预测价值(P<0.01)。结论住院SCZ患者发生营养状态异常现象多见,临床应及早关注,并针对性地提供合理、有效、个性化的营养干预,以降低SCZ患者营养不良发生率,提高生存质量,延长生命周期,减少医疗支出。Objective To evaluate the nutritional status of hospitalized patients with schizophrenia(SCZ)and analyze its influencing factors.Methods Demographic data,medical history data,physical measurement indicators,and multiple laboratory nutritional metabolism indicators were collected from 401 hospitalized SCZ patients.According to the Controlling Nutritional Status(CONUT)score,hospitalized SCZ patients were divided into two groups:malnutrition group and normal nutrition group.The differences in clinical data between two groups,including general conditions and various nutritional and metabolic indicators were compared.The risk factors for abnormal nutritional status in hospitalized SCZ patients were analyzed,and a risk prediction efficacy analysis on whether hospitalized SCZ patients had abnormal nutritional status was conducted.Results The detection rate of malnutrition was 39.40%,with mild malnutrition accounting for 33.67%and moderate malnutrition accounting for 5.74%.No severe malnutrition was detected.The proportions of males and comorbidities as well as age and disease course in malnutrition group were higher than those in normal nutrition group(P<0.05);the BMI,SBP,DBP,and levels of Hb,WBC,TP,PA,TG,LDL-C,and SUA in malnutrition group were all lower than those in normal nutrition group(P<0.01).Abnormal nutritional status was significantly positively correlated with age,disease course,and comorbid physical diseases(P<0.001),and negatively correlated with male,BMI,SBP,DBP,Hb,WBC,TP,PA,TG,LDL-C,and SUA(P<0.05).Male,comorbid physical diseases,low BMI,low levels of Hb,WBC,PA,and LDL-C were risk factors for abnormal nutritional status(P<0.05).LDL-C,Hb,PA,BMI,WBC and combination of physical diseases had predictive value for the occurrence of nutritional abnormalities in hospitalized SCZ patients(P<0.01).Conclusion Nutritional abnormalities are common in hospitalized SCZ patients,and clinical attention should be paid early and targeted,effective,and personalized nutritional interventions should be provided to reduce the i

关 键 词：精神分裂症 营养不良 影响因素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]