抗精神病药物引起患者体质量增加相关因素分析

A study on the cause of inducing patients' weight gain by taking anti-psychotic drugs and other related clinical factors

目的探讨抗精神病药引起患者体质量增加的相关因素。方法对67例首次住院单用抗精神病药治疗的精神分裂症患者,采用自编定式表格、简明精神病量表、阴性症状量表、阳性症状量表,进行住院及出院后4个月的体质量随访评估。结果各时点体质量增加与GI评分无相关性,体质量增加在出院时与简明精神量表、阳性症状量表减分值有相关性,而随访期与阴性症状量表减分值有相关意义。逐步回归分析显示,在α=0.05水平上,进入回归方程的因素依次为抗精神病药品种、最大服药剂:量与服药时间的积、阴性症状、病前1年最佳功能水平。结论抗精神病药治疗中的体质量增加,是与疗效无关的药物不良反应,其形成受药物、精神症状及综合社会心理因素等方面的影响,而饮食与活动的中介作用不应低估。控制体质量增加有重要的医学社会意义。

Objective To investigate the cause of inducing patients' weight gain by taking anti-psychotic drugs (APD) and other related factors. Methods 67 patients with schizophrenia who were hospitalized for first time and took APDs only were followed up and evaluated about their weight changes in our hospital and out of hospital in the following four months by using self-designed format table, BPRS, SANS and SAPS. Results Patients' weight increasing in different time didn't relate to the GI value, but the reduced values of BPRS,SAPS in hospital and SANS out of hospital. Stepwise regress analysis read that the patients' weight gain really related to the types of APD, the product of the APDs' draught and the interval between two times of their taking medicine, negative symptom and the best level of patients' body conditions one year before schizophrenia. Conclusion Patients' weight gain by taking anti-psychotic drugs significantly relates to the side effects of APD, which has not curative effect, patients' mental symptoms, comprehensive social psychological factors and other relative factors, such as patients' foods and their exercises. It is of social and medical significance to curb or restrain patients' weight increase.