长期住院精神分裂症患者血尿酸水平与抗精神病药物应用的调查研究

Investigation of relation of application of antipsychotics and serum uric acid level of long- term hospitalized schizophrenics

目的:了解长期住院精神分裂症患者高尿酸血症的发生与抗精神病药物应用的关系及其影响因素。方法:选取433例精神分裂症男性患者作为研究对象,均符合ICD-10精神分裂症诊断标准。采用自制的调查表对所有入组对象进行调查;抽取患者空腹静脉血5ml,检测血尿酸、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、血糖。以病程为分组标准,将患者分为5组:Ⅰ(<20年),Ⅱ(20-30年),Ⅲ(30-40年),Ⅳ(40-50年),Ⅴ(>50年),分别为47人、86人、115人、133人、52人,探讨各组分之间的特点。结果:服用二代抗精神病药物的患者中,第Ⅴ组患者的尿酸值比前3组任意一组都低,结果有统计学意义(P<0.05)。在433例患者中,服用一种抗精神病药物的患者为310例,高尿酸血症的发生率为12.26%(38/310);联合服用抗精神病药物的患者为78例,发生率为8.97%(7/78);未服抗精神病药物的患者为45例,发生率为8.89%(4/45)。组间比较无统计学意义(P>0.05)。以高尿酸血症为因变量,年龄、病程、PANSS评分、代谢综合征为自变量的多元线性回归分析发现,只有代谢综合征具有统计学意义(P<0.05,R2为0.371)。结论:服用二代抗精神病药物的患者尿酸值在病程50年后明显比30年内低。精神分裂症病患者是否服药及单一用药或者是联合用药对高尿酸血症没有影响。代谢异常能解释高尿酸血症发生的37.1%。

Objective To investigate relation of application of antipsychotics and hyperuricemia of long-term hospitalizedschizophrenics and its influencing factors. Methods： 433 male schizophrenic patients staying in a hospital for a long time were selectedto be researched and all of them reached ICD-10 diagnose criterion for schizophrenia. We used a self-made questionnaire to investi鄄gate all selected objects; and we took 5 ml blood, and then measured uric acid, triglycerides, total cholesterol, HDL, LDL, glucose.According to the course of disease, the patients were divided into 5 groups, Ⅰ（〈20 years）, Ⅱ（20-30 years）, Ⅲ（30-40 years）,Ⅳ（40-50 years）, Ⅴ（〉50 years）, and the features of different groups were discussed. Results： For the patients taking secondgenerationantipsychotics, the uric acid level of group Ⅴ was lower than anyone of first three groups, and the differences were statistically significant （P〈0. 05）. Among the 433 patients, 310 cases took a single antipsychotic with the incidence of hyperuricemia of12. 26% （38/310）, 78 cases took the combined antipsychotics with the incidence of hyperuricemia of 8. 97 % （7/78）, and 45 casesdidn＇t take any antipsychotic with the incidence of hyperuricemia of 8. 89% （4/45）. The differences between the two groups were notstatistically significant （P〉0. 05）. Using hyperuricemia as the dependent variable and age, duration, PANSS score, metabolism syndrome as the independent variables, the multivariate linear regression syndrome found that only metabolic syndrome was statisticallysignificant （P〈0. 05, R2=0. 371）. Conclusions： This study indicates that among the patients who have taken the second-generationantipsychotics, those with the course of disease of over 50 years have significantly lower levels of uric acid than those with the course ofless than 30 years. The monotherapy or combination therapy has no effects on hyperuricemia. Metabolic abnormalities can explain37. 1% of hyperuricemia occurring.