上海市某社区精神病患者体检结果分析

Analysis of physical examination results of psychotic patients in a community of Shanghai

目的 :分析社区内的精神病患者体检的结果,为家庭医生对精神患者的连续综合管理提供依据。方法 :对2014年4月至2015年4月在欧阳社区在册管理且病情稳定能够参加体检的400例精神病患者的体检资料进行分析,男性204人(占51%),女性196人(占49%),年龄22~100岁,平均年龄(57.22±14.06)岁。其中86.00%(344/400)为精神分裂症患者。结果 :在400例精神病患者中,吸烟率为24.5%(98/400),每天饮酒率为12.3%(49/400),缺乏锻炼者的比例为70.8%(283/400);心电图异常检出率为54.8%(219/400),体重超重率为35.8%(143/400),血压升高检出率为29.0%(116/400),空腹血糖升高检出率为17.5%(70/400),肝功能异常检出率为5.5%(22/400),肾功能异常检出率为0.8%(3/400)。60岁及以上年龄组的血压升高和血糖升高的检出率高于60岁以下年龄组(P<0.01)。自报有高血压和糖尿病患者的血压和血糖控制达标率分别为30.35(17/56)和37.25(19/51)。结论 :本社区精神病患者中有较高的不良生活方式;自报有高血压和糖尿病患者的血压和血糖控制达标率较低。较高心电图异常检出率应警惕与长期服用抗精神类药品致心肌损害有关。提示社区应定期开展体检筛查,帮助家庭医生有针对性地对精神患者进行分层管理,提高管理效果。

Objective： To analyze the physical examination results of psychotic patients in the community to provide the basis for the continuous and comprehensive management of psychotic patients for family doctors. Methods： The physical examination data of 400 psychotic patients who were registered in the management of Ouyang Community and were stable and able to take the physical examination were analyzed from April 2014 to April 2015, and among of them there were 204 males（51%） and 196 females（49%）, and their ages were 22~100 years old, with an average age of（57.22±14.06） years. Of them, 86%（344/400） were schizophrenic patients. Results： In 400 patients, smoking rate was 24.5%（98/400）, daily drinking rate was 12.3%（49/400）, lack of exercise ratio was 70.8%（283/400）; the detection rate of abnormal ECG was 54.8%（219/400）, overweight rate was 35.8%（143/400）, detection rate of high blood pressure was 29.0%（116/400）, the elevated fasting blood glucose was 17.5%（70/400）, detection rate of abnormal liver function was 5.5%（22/400）, and detection rate of abnormal renal function was 0.8%（3/400））. The prevalence of elevated blood pressure and elevated blood glucose levels in patients aged 60 years and older was higher than the prevalence of elevated blood pressure and elevated blood glucose levels in the age group under 60 years old（P0.01）. The control rates of blood pressure and glycemic control of self-reported hypertension and diabetes mellitus patients were 30.35（17/56） and 37.25（19/51）, respectively. The self-reported blood pressure and glycemic control rates were low. Conclusion： There is a higher unhealthy lifestyle in this community, and hypertension and diabetes have lower blood pressure and glycemic control rates. The higher rate of abnormal detection of ECG should be concerned with the myocardial damage caused by long-term use of antipsychotic drugs. It is suggested that the community should carry out physical examination screening regularly, and help family doctors carry out the stratified management of psychotic patients, so as to improve the management effect.