女性精神分裂症患者治疗后体质量增加的影响因素

Influencing factors of weight gain in women with schizophrenia after treatment

目的探讨女性精神分裂症患者治疗后体质量增加的影响因素。方法对2016年1~12月在丽水市第二人民医院首次住院、单用抗精神病药(APD)治疗的女性精神分裂症患者180例进行住院及出院后4个月的随访观察。分别测量身高、体质量及体质量指数,联合一般情况调查表、简明精神病量表(BPRS)、阴性症状量表(SANS)、阳性症状量表(SAPS)和临床疗效总评量表的分量表-疗效总评(CGI-GI)进行综合评估。结果体质量增加与抗精神病药的种类有关(χ2=37.3,P<0.01),其中以阿立哌唑及齐拉西酮对体质量的影响作用明显少而轻(χ2=31.1,P<0.01)。单因素分析显示与服药时间有一定相关性(F=4.92,P<0.05),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BPRS、SAPS减分值有相关性(r=0.079、0.092,均P<0.01),而随访期与SANS减分值有相关性(r=-0.063、-0.086,P<0.05或P<0.01);逐步回归分析显示,在α=0.05水平上,进入回归方程因素依次为:APD种类,最大服用剂量与服用时间的积,阴性症状,病前1年最佳功能水平。结论控制年轻女性患者体质量增加具有重要的意义,选用适宜的APD,酌情调整维持治疗策略,改善阴性症状,提高个体社会功能水平为主要干预措施。

Objective To explore the influencing factors of weight gain in women with schizophrenia after treatment. Methods From January 2016 to December 2016,180 patients with schizophrenia who admitted to the Second People′s Hospital of Lishui for the first time and were treated with antipsychotics(APD) were followed up at hospital and 4 months after discharge.The height,weight and body mass index were observed.The joint general situation questionnaire,brief psychiatric scale(BPRS),negative symptoms(SANS),positive symptom scale(SAPS) and the clinical curative effect overall rating scale subscales of overall curative effect(CGI-GI) were comprehensively evaluated.The data were analyzed statistically. Results The weight gain was related to the type of antipsychotics(χ2=37.3,P<0.01),and the effect of aripiprazole and ziprasidone on body weight was significantly less than that in the case of weight(χ2=31.1,P<0.01).Single factor analysis showed that a medication time correlation(F=4.92,P<0.05),and each point GⅠ score had no correlation with weight gain,and weight gain was associated with BPRS,SAPS subtraction score at discharge(r=0.079,0.092,all P<0.01),and during follow-up weight gain was correlated with SANS score reduction (r=-0.063,-0.086,P<0.05 or P<0.01).Stepwise regression analysis showed that at the alpha=0.05 level,entered the regression equation factors in the order: APD types,maximum doses and taking the product of time,the negative symptoms,the best functional level at 1 year before disease. Conclusion It is important to control the weight gain of young women.The mediating role of diet and activity should not be underestimated.Appropriate APD was chosen to adjust the maintenance treatment strategy as appropriate,improve the negative symptoms and improve the level of individual social function as the main intervention measure.