慢性精神分裂症患者伴发代谢综合症临床探究.docVIP

慢性精神分裂症患者伴发代谢综合症临床探究 　 作者：朱卫明 易正辉 丁宇杰 龙彬 朱丽萍 吴国君 【摘要】 目的 探讨长期服用氯氮平治疗的慢性精神分裂症患者伴发代谢综合症的发生率及其相关因素。 方法 对124例长期服用氯氮平治疗的慢性精神分裂症患者的一般资料进行统计整理，并测量身高、体重、腰围和血压，测定空腹血糖、血总胆固醇、甘油三脂、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇及氯氮平血药浓度，对检测结果进行相关分析。 结果 长期服用氯氮平的慢性精神分裂症患者中糖尿病发生率19.4%、高血压发生率12.1%、肥胖发生率54.0%、血脂紊乱发生率55.6%，代谢综合症发生率14.5%，其中女性患者肥胖发生率显著高于男性（P＜0.05）。相关因素分析显示，血压、血脂与性别有关，血压、BMI、血脂及腰围与氯氮平最高剂量有关。 结论 长期服用氯氮平治疗的慢性住院精神分裂症患者伴发代谢综合症的发生率较高，其与性别及服用氯氮平的最大剂量有关。 【关键词】 慢性精神分裂症；氯氮平；代谢综合症 【Abstract 】 Objective To investigate the prevalence of metabolic syndrome in inpatients with chronic schizophrenia treated with clozapine and analyze the correlation between metabolic syndrome and the related factors . Methods 124 inpatients with chronic schizophrenia treated with clozapine were assigned to conduce physical examinations including measurement of height, weight, waist circumference and blood pressure，and laboratory tests including fasting blood glucose , total cholesterol , triglyceride , HDLC and LDLC. Results The prevalences of the diabetes, hypertension, obesity, dyslipidemia and MS among inpatients of chronic schizophrenia treated with clozapine were 19.4 %, 12.1%, 54.0%, 55.6% and 14.5% respectively. There were significant difference on prevalence of obesity between male and female patients, and female patients had higher prevalence of obesity than males. Blood pressure and blood lipid were related with gender, and blood pressure, BMI, blood lipid and waist circumference were related with the highest dose of clozapine. Conclusion There is high prevalence of metabolic syndrome in inpatients of chronic schizophrenia treated with clozapine, and it is related with gender and the highest dose of clozapine. 【Keywords】 Chronic schizophrenia；clozapine;metabolic syndrome; 代谢综合症(Metabolic syndrome，MS)是一种涉及多种代谢异常、与心血管病紧密联系的疾病状态，其中以肥胖(超重)、血压、血糖和血脂四项异常为突出，曾被称为死亡四重奏，患者因心脑血管事件死亡的危险性显著增加［1］。近年来，精神分裂症合并MS的现象已引起了人们的关注，国内外有关精神分裂症合并糖尿病的研究较多［2～4］，而国内对合并MS研究较少。故本文对此予以研究。 1 对象与方法 1.1 对象 样本选自在上海市精神卫生中心分部住院的精神分裂症患者。入组标准：（1）符合《中