精神分裂症患者性别差异研究

Gender differences in patients with schizophrenia

目的探讨不同性别精神分裂症患者的体质量指数(BMI)、糖脂代谢及阳性和阴性症状量表(PANSS)评分的差异。方法选择2009年4月至2010年7月新乡医学院第二附属医院收治的精神分裂症患者243例为研究对象。所有患者分别使用单一抗精神病药物进行治疗,治疗2个月时测患者身高、体质量及血浆空腹血糖(GLU)、三酰甘油(TG)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)水平,同时采用PANSS评估患者的精神症状。结果女性患者发病年龄大于男性患者,女性患者的住院次数及血浆GLU、HDL水平高于男性患者,女性患者的阳性因子、兴奋因子及抑郁因子得分显著高于男性患者(P<0.05)。女性患者使用利培酮的比例高于男性患者(P<0.05)。男性和女性患者的认知因子和阴性因子得分、肥胖发生率及BMI比较差异均无统计学意义(P>0.05)。男性患者BMI与血浆TG、HDL、LDL及GLU水平均无相关性(r=0.103、0.022、0.065、0.169,P>0.05);女性患者BMI与血浆TG水平呈正相关(r=0.181,P<0.05),与HDL、LDL及GLU水平无相关性(r=0.002、0.097、0.151,P>0.05)。男性和女性患者的BMI与PANSS总分、阳性因子得分、阴性因子得分、兴奋因子得分、抑郁因子得分和认知因子得分均无相关性(r_(男性)=-0.016、0.067、0.059、0.076、-0.075、-0.015,r_(女性)=-0.053、-0.064、0.008、-0.066、0.084、-0.096;P>0.05)。结论精神分裂症患者在BMI、肥胖发生率、认知因子得分及阴性因子得分方面不存在性别差异,在发病年龄、住院次数、血浆GLU和HDL水平、阳性因子得分、兴奋因子得分及抑郁因子得分方面存在性别差异,提示临床医师对不同性别的精神分裂症患者的预防、治疗和康复应区别对待。

Objective To investigate differences of the body mass index(BMI),plasma glucose metabolism,plasma lipid metabolism,positive and negative symptom scale(PANSS)score of schizophrenia patients with different genders.Methods A total of 243 schizophrenic patients in the Second Affiliated Hospital of Xinxiang Medical University from April 2009 to July 2010 were selected as subjects.All patients were treated with a single antipsychotic drug for two months.After two months treatment,the height,body mass,plasma fasting blood glucose(GLU),triglyeride(TG),high density lipoprotein(HDL)and low density lipoprotein(LDL)levels of patients were measured,and the PANSS was used to assess the patient′s mental symptoms.Results The age of onset of female patients was significantly later than that of male patients(P<0.05);the frequency of hospitalization and the levels of plasma GLU and HDL in female patients were significantly higher than those in male patients(P<0.05);the scores of positive factor,excitability factor and depression factor of female patients were significantly higher than those of male patients(P<0.05).The proportion of risperidone in female patients was significantly higher than that in male patients(P<0.05).There was no significant difference in the scores of cognitive factors and negative factors,incidence of obesity and BMI between male and female patients(P>0.05).There was no correlation between BMI and plasma TG,HDL,LDL and GLU levels in male patients(r=0.103,0.022,0.065,0.169;P>0.05).The BMI was positive correlated with plasma TG levels in female patients(r=0.181,P<0.05)and was not correlated with plasma HDL,LDL and GLU levels(r=0.002,0.097,0.151;P>0.05).There was no correlation between BMI and PANSS scores,positive factor scores,negative factor scores,excitatory factor scores,depression factor scores and cognitive factor scores in male and female patients(r male=-0.016,0.067,0.059,0.076,-0.075,-0.015;r female=-0.053,-0.064,0.008,-0.066,0.084,-0.096;P>0.05).Conclusion There is no gender difference in BMI,obesity,in-ward frequency,cognitive factor scores and negative factor scores in patients with schizophrenia;there is gender difference in age of onset,GLU and HDL levels,positive factor score,excitatory factor score and depression factor score.