长期服用氯氮平的精神分裂症慢性期患者体重指数与精神病理症状关系

Relationship between body mass index and psychiatric symptoms in chronic schizophrenic patients treated with long-term clozapine

目的探讨氯氮平长期治疗对精神分裂症慢性期患者体重指数(BMI)及其精神病理症状的影响。方法选择我院病程5年以上、服用氯氮平至少12月的精神分裂症慢性期住院患者共141例,按性别将其分为两组,根据患者身高和体重计算其BMI,各组再按BMI分为低体重组、正常体重组、超重组和肥胖组,以阳性与阴性症状量表(PANSS)评估患者的精神病理症状,分析各组BMI与PANSS评分的相关性。结果女性组超重及肥胖患者所占比例(80.8%)显著高于男性组(57.3%),但女性组患者BMI增加与临床病理症状改善间并无显著相关性(P>0.05)。男性组肥胖、超重、正常体重和低体重各亚组间患者PANSS阴性症状分量表分、一般病理症状分量表分和总分均存在差异,与正常体重和低体重组相比,肥胖和超重组患者上述三项量表分均较低,且差异有统计学意义(P<0.05);男性组患者BMI与上述三项量表分呈显著负相关,与PANSS阳性症状分量表分则无显著相关性。结论长期服用氯氮平的精神分裂症慢性期患者BMI明显增加,女性病例体重增加者占比高于男性;男性组患者BMI增加与其临床症状、尤其是阴性症状和一般病理症状的改善呈显著相关性,女性组患者BMI与其精神症状间无显著相关性。

Objective To investigate the relationship between body mass index （BMI） and psychiatric symptoms in chronic schizophrenic patients treated with long-term clozapine. Methods Totally 141 chronic schizophrenic patients whose course of disease were at least 5 years and administration time of clozapine were at least 12 months were divided into male group and female group. Each group was divided into low weight group,normal weight group,overweight group and obesity group furtherly according to BMI. The psychiatric symptoms of patients were assessed with the positive and negative syndrome scale（ PANSS）. The correlation between BMI and PANSS scores was analyzed. Results The proportion of overweight and obesity patients in female group（80.8%） was signifi cant higher than that in male group（57.3%）,and there was no correlation between BMI and psychiatric symptoms in female group. There were significant differences in PANSS negative symptom subscale（N scale） scores,general symptom subscale（G scale） scores and total scores among the four subgroups of male group. Compared with normal weight and low weight subgroups,the total scores,N scale scores and G scale scores of obesity and overweight subgroups reduced signifi cantly（P〈0.05）. There were negative correlations among BMI and N scale scores,G scale scores as well as total scores in male,and there was no correlation between BMI and positive symptom subscale scores. Conclusion BMI increases significantly in chronic schizophrenic patients treated with long-term clozapine,and the number of overweight and obesity patients in women is higher than that in men. The increase of BMI is related to the improvement of clinical symptoms,especially negative symptoms and general patho-symptoms in men,and there has no correlation between BMI and psychiatric symptoms in women.