社区精神疾病患者血生化检查及其对攻击行为的影响研究

Blood Biochemical Examination of Psychiatric Patients in Community and Its Influence on Aggressive Behavior

目的检测社区精神疾病患者的血生化检查指标水平,并探讨其对攻击行为的影响。方法于2014年4—8月选取在北京市田村社区卫生服务中心、永定路社区卫生服务中心、万寿路社区卫生服务中心、玉渊潭社区卫生服务中心、八里庄社区卫生服务中心、方庄社区卫生服务中心、月坛社区卫生服务中心接受社区精神卫生服务的精神疾病患者193例。检测并记录其血生化检查指标,包括总胆固醇(TC)、三酰甘油(TG)、三碘甲状腺原氨酸(T_3)、甲状腺素(T_4)、促甲状腺激素(TSH)、睾酮(T)及血总皮质醇(F)。随访3个月,记录患者的攻击行为发生情况。结果共165例患者完成了随访,其中21例(12.7%)的TC高于参考范围,69例(41.8%)的TG高于参考范围,81例(49.1%)的T高于参考范围。共10例(6.1%)患者发生了攻击行为,不同攻击行为发生情况患者的TC、TG、T_4、TSH、T、F比较,差异无统计学意义(P>0.05);发生攻击行为患者的T_3高于未发生患者,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,T_3、TSH是社区精神疾病患者发生攻击行为的影响因素(P<0.05)。结论大部分社区精神疾病患者的血生化检查指标在参考范围内,且攻击行为发生率较低,T_3、TSH是其发生攻击行为的影响因素。

Objective To investigate the index level of blood biochemical examination of psychiatric patients in community,and explore its influence on aggressive behavior. Methods 193 psychiatric patients who received community mental health service in community health service centers of Tiancun, Yongding Road, Wanshou Road, Yuyuantan, Balizhuang,Fangzhuang,Yuetan,Beijing from April to August,2014. Their biochemical examination indexes were detected and recorded,including total cholesterol（ TC）, triacylglycerol（ TG）, triiodothyronine（ T_3）, thyroxine（ T_4）, thyroid- stimulating hormone（ TSH）,testosterone（ T） and plasmatotalcortisol（ F）. Three- month follow- up visit was conducted to record the occurrence of aggressive behavior of patients. Results The follow- up visits of 165 patients were finished,among them,TC of21 cases（ 12. 7%）,TG of 69 cases（ 41. 8%）,T of 81 cases（ 49. 1%） were higher than the reference range,10 cases（ 6. 1%） had aggressive behavior,and the comparison of TC,TG,T_4,TSH,T,F of patients with different occurrence of aggressive behavior showed that the differences were not statistically significant（ P〉0. 05）; T_3 of patients with aggressive behavior was higher than those without agresseive behavior,the differences were statistically significant（ P〈0. 05）. Multiple Logistic regression revealed that T_3 and TSH were influencing factors of aggressive behavior of community psychiatric patients（ P〈0. 05）. Conclusion The index levels of blood biochemical examination of most community psychiatric patients were in reference range; the occurrence rate of aggressive behavior was relative low, T_3 and TSH are the influencing factors of the occurrence of aggressive behavior of community psychiatric patients.