影响首发老年精神分裂症患者预后不良的危险因素

Risk factors of poor prognosis for the first episode senile schizophrenia patients

目的探讨影响首次发病的老年精神分裂症患者(年龄≥60岁)预后不良的危险因素。方法收集2013年2月至2015年2月在我院住院的首次发病的老年精神分裂症患者256例为研究对象,按照出院后随访1年时的大体评定量表(GAS)评分将患者分为A组(预后不良组,GAS<61分,n=71例)和B组(预后良好组,GAS≥61分,n=185例),比较两组一般临床资料、实验室检查指标的差异,并利用Logistic回归方程分析影响老年精神分裂症患者预后不良的相关因素。结果单因素分析提示两组患者在受教育程度、婚姻状况、家庭经济收入、高血压、代谢综合症、血清超敏C反应蛋白(hs-CRP)、D-二聚体、泌乳素方面存在统计学差异(P<0.05);多因素Logistic回归分析最终筛选出家庭经济收入偏低、合并高血压、代谢综合症、血清hs-CRP≥7 mg/L、D-二聚体≥400μg/L、泌乳素≥30μg/L是老年精神分裂症患者(年龄≥60岁)预后不良的独立危险因素。结论首次发病的老年精神分裂症患者预后情况受到诸多因素影响,庭经济收入偏低、合并高血压、代谢综合症、高水平血清hs-CRP、D-二聚体、泌乳素等是其独立影响因素,应当引起临床中高度重视。

Objective To investigate the risk factors of poor prognosis for the first episode senile schizophrenia patients （ age ≥ 60 ） . Method From February 2014 to May 2016 256 cases of first episode senile schizophrenia patients treated in the hospital were selected as the research objects, according to the Global Assessment Scale （ GAS ） scores in the follow-up of 1 year after discharge , all the patients were devided into group A （ poor prognosis group, GAS 〈 61 points, n=71 ） and group B （good prognosis group, GAS 61 points or more, n=185 ）, the general clinical data, laboratory examination parameters between the two groups were compared. By using Logistic regression equation analysis , the risk factors affecting the poor prognosis of senile patients with first episode schizophrenia were analyzed. Results The single-factor analysis of the two groups showed that there were statistical differences in the level of education, marital status, family income, hypertension, metabolic syndrome and serum hypersensitive c-reactive protein （hs - CRP）, D - dimer, prolactin （P〈0.05）; Muhiariable Logistic regression analysis showed that the lower family economic income, hypertension, metabolic syndrome, hs-CRP ≥ 7 mg/L, D - dimer ≥400μg/L, prolactin≥ 30μg/ L were the risk factors of poor prognosis for the first episode senile schizophrenia patients （ age ≥ 60 ） . Conclusion The prognosis of the first episode senile schizophrenia patients is affected by many factors, lower family economic income, hypertension, metabolic syndrome, high levels of serum hs - CRP, D - dimer and prolaetin are all independent risk factors affecting for poor prognosis of these patients, thus, these risk factors should be paid more attention.