精神分裂症患者压缩性骨折影响因素分析

Analysis on influencing factors for compression fractures in patients with schizophrenia

目的比较有和无椎体压缩性骨折的精神分裂症患者的临床特征,为椎体压缩性骨折的预防提供相应的对策与措施。方法回顾性研究将2013年1月至2015年12月首都医科大学附属北京安定医院新入院的精神分裂症患者连续入组,按照有、无椎体压缩性骨折,分为骨折组(n=52)和未骨折组(n=5 507),比较其临床特征,观察精神分裂症胸腰椎压缩性骨折用药情况和压缩性骨折部位;通过Logistic回归分析探讨精神分裂症患者椎体压缩性骨折的相关危险因素。结果与未骨折组相比,骨折组年龄更大[(54.96±14.31)岁vs.(34.8±13.6)岁,t=11.61],血钙值更低[(2.18±0.1)mmol/L vs.(2.29±0.11)mmol/L,t=-7.02],血催乳素值更高[(69.49±44.11)ng/ml vs.(35.40±12.06)ng/ml,t=5.17],女性更多(61.5%vs.49.8%,χ~2=6.74),吸烟者更多(28.8%vs.0.7%,χ~2=450.42),差异均具有统计学意义(P<0.01)。骨折组主要以非典型抗精神病药物治疗为主,压缩性骨折部位为胸椎、腰椎。Logistic回归分析显示,吸烟(OR:110.619,95%CI:40.920~299.038)、年龄大(OR:1.136,95%CI:1.104~1.169)、血钙值低(OR:0.001,95%CI:0.000~0.021)、血催乳素值高(OR:1.021,95%CI:1.014~1.028)与精神分裂症发生压缩性骨折呈正相关(P<0.01)。结论吸烟、年龄大、血钙值低、血催乳素值高可能是精神分裂症发生压缩性骨折的独立危险因素。

Objective To compare various the risk factors of patients with schizophrenia with or without compression fractures. Methods Inpatients with schizophrenia in this hospital during January 20113 to December 2015 were divided into 2 groups; group with（ n = 52） and group without（ n = 5 507） compression fractures. Demographic and clinical features were compared between these two groups. The medication and site of compression fracture at thoraco-lumbar spines in patients with schizophrenia had been observed. Multiple logistic regression analysis had been applied to assess the risk factors of schizophrenia patients with compression fractures. Results In comparison with patients in without compression fractures group,patients in compression fracture group had significantly older age [（ 54. 96 ± 14. 31） years old vs..（ 34. 8 ± 13. 6） years old,t = 11. 61],female ratio（ 61. 5% vs. 49. 8%,χ~2= 6. 74）,smoking（ 28. 8% vs. 0. 7%,χ~2= 450. 42）,blood levels of calcium [（ 2. 18± 0. 1） mmol/L vs.（ 2. 29 ± 0. 11） mmol/L,t =-7. 02],serum levels of prolactin [（ 69. 49 ± 44. 11） ng/m L vs.（ 35. 40 ± 12. 06） ng/m L,t = 5. 17]（ P 〈 0. 01）. Patients in compression fracture group were mainly treated with atypical antipsychotic drugs,and their sites for compression fracture were at thoraco-lumbar spines. Logistic regression analysis showed that smoking（ OR： 110. 619,95% CI： 40. 92 ~ 299. 038）,elder age（ OR： 1. 136,95% CI： 1. 104 ~ 1. 169）,blood levels of calcium（ OR： 0. 001,95% CI： 0. 000 ~ 0. 021） and serum levels of prolactin（ OR： 1. 021,95% CI： 1. 014 ~ 1. 028） were significantly correlated with compression fracture in patients with schizophrenia（ P 〈 0. 01）. Conclusion This study indicates that smoking,elder age,blood levels of calcium and serum levels of prolactin may be the key independent risk factors for the ocurrence of compression fracture in patients with schizophrenia.