精神分裂症与吸烟行为的关系

Relationship between schizophrenia and smoking behavior

目的:临床中发现,精神分裂症患者与普通人群相比,具有更高的吸烟率,对尼古丁的依赖程度也更大。本文就精神分裂症与吸烟行为的研究进展作一综述。资料来源:应用计算机检索HighWire Press 1844/2006有关精神分裂症和吸烟相关的论文,检索词为“schizophrenia,smoking”,限定语言种类为英文。同时检索维普数据库1989/2006有关文献,检索词为“精神分裂症,吸烟”,并限定语言种类为中文。资料选择:纳入标准:选择探讨吸烟与精神分裂症之间的关系及相关影响因素或内在机制的文章。排除标准:排除综述类文献。资料提炼:对资料进行初审,并查看引文。共收集到30篇符合以上要求的文献,涉及精神分裂症患者的吸烟情况调查、尼古丁依赖情况、吸烟对精神分裂症的影响及精神分裂症患者高吸烟率发生的机制等方面。资料综合:精神分裂症与吸烟行为的某些性状之间存在相关性。精神分裂症患者的吸烟年龄早于其发病年龄,患病不会使他们的吸烟行为发生,只会使其吸烟性状加重。并且吸烟对精神分裂症的阴性症状、阳性症状以及认知功能都有影响,比较一致的结论是吸烟可以缓解精神分裂症患者认知功能的损害。但吸烟也会降低抗精神病药物的血药浓度,且突然中断吸烟可能诱发或加重某些药物副反应。吸烟行为可能作为精神分裂症发病的一个危险因素,其相对危险度尚无肯定结论。结论:吸烟行为和精神分裂症患者的发病及症状之间相互影响,并可能作为精神分裂症的内表型之一存在。其内在的作用机制尚不明确,尼古丁受体基因的研究可能是一个突破口,有待进一步的研究证实。

OBJECTIVE： It is found that the smoking rate of schizophrenia patients Is higher than common population in clinic, so is the nicotinic dependency level. To summarize the progression of schizophrenia and smoking behavior in this paper. DATA SOURCES： A computer-based online search in HighWire Press was undertaken for related articles of schizophrenia and smoking published in English between 1844 and 2006 with the key words of ＂schizophrenia, smoking＂. Meanwhile, we searched VIP database for related articles between 1989 and 2006 with the same key words in Chinese. STUDY SELECTION： Inclusive criteria： articles about the relationship between smoking and schizophrenia or the related influencing factors and intemal mechanisms. Exclusive criteria： review articles. DATA EXTRACTION： The data ware selected firstly, and the references of each article ware looked up. A total of 30 articles met the inclusive criteria ware collected, which referred to the smoking condition of schizophrenia, nicotine dependence, the influence of smoking on schizophrenia and probable mechanisms of high smoking rate. DATA SYNTHESIS： There was correlation between schizophrenia and smoking behavior. The age of smoking initiation was eadier than the age of onset, and the disease would not cause them to leam smoking, but aggravating the nicotine dependence level. Smoking also influenced the negative symptoms, positive symptoms and cognition, and it was consistent that smoking could relieve the cognitive impairment of schizophrenia. But smoking could degrade the blood level of antipsychotic, and interruption of smoking might induce or aggravate adverse reaction of some antipsychotic. A few perspective studies regarded smoking behavior as a dangerous factor and got a relative risk, but the outcomes ware quite different. CONCLUSION; Smoking behavior and schizophrenia influence each other, and smoking maybe exist as one of Jnner-pbenotypes of schizophrenia. But it is not clear what the mechanism is; the study about nicotinic receptor gone should be a breakthrough and yet need to be confirmed.