精神分裂症患者骨密度状况及影响因素研究

Bone mineral density of schizophrenia patients and its influencing factors

目的探讨精神分裂症患者骨密度状况及影响因素,为精神科护理风险的评估及采取干预措施提供参考依据。方法选择住院精神分裂症患者1 139例作为研究对象,根据既往是否接受抗精神病药物治疗分为服药组(652例)和未服药组(487例)。使用调查问卷收集患者的临床资料;采用以色列阳光骨龄7 000超声骨强度仪进行骨密度值测定;抽取空腹静脉血测定血钙、血磷和血清催乳素含量。结果两组在年龄、骨密度值、饮食牛奶量、活动程度、吸烟程度、跌倒史、骨折史、血清钙及血清催乳素等方面差异均具有统计学意义(P<0.05);疾病的不同病程、服药的不同药龄与骨密度等级分布差异具有统计学意义(P<0.001);多元线性回归显示,对骨密度值影响有统计学意义的因素有病程、药龄、血清钙、血清催乳素、饮食牛奶量、活动程度和吸烟程度。结论服药组骨密度值较未服药组低,其骨质疏松的发生与多种因素具有相关性。临床护士应全面把握高危因素,及早采取护理干预措施。

Objective To explore the bone mineral density （BMD） status and its influencing factors in schizophrenia patients in order to provide basis for risk assessment in psychiatric nursing. Methods A total of 1,139 hospitalized schizophrenia patients were recruited and assigned into the medication group （n=652） and the non-medication group （n=487） according to previous antipsyehotic drug history. T-score and Z-score of BMD were determined using Sunlight Omnisense 7000S Bone Densitometry. Blood calcium,blood phosphorus and serum prolaetin levels were measured using fasting blood of ulnar vein. Results Differences in age ,BMD,milk intake,level of activity,level of smoking,history of fall,history of fracture,serum Ca2＋ and PRL were statistically significant between two groups（P〈0.05）; there were significant differences in BMD rank distributions among schizophrenia patients with different courses of disease and lengths of taking antipsychotics （P〈0.001）; multiple linear regression showed that influencing factors of BMD with statistical significance were courses of disease,lengths of taking antipsychotics, serum Ca2＋,serum PRL,milk intake,level of activity,and level of smoking. Conclusion The BMD was lower in the medication group than that in the non-medication group,and the development of osteoporosis was correlated to various factors. Clinical nurses should master high-risk factors thoroughly and adopt intervention measures in a timely manner.