抗精神病药导致糖尿病的相关危险因素Logistic回归分析

Regression analysis of risk factors related to antipsychotics-induced diabetes mellitus

目的探讨抗精神病药物治疗精神分裂导致患者发生糖尿病的原因。方法105例精神分裂患者均采用抗精神病药物进行治疗,对其临床资料进行分析,收集精神分裂患者糖尿病的发生情况及导致糖尿病发生的相关影响因素,采用多因素Logistic回归方法分析精神分裂患者服用抗精神病药物后发生糖尿病的影响因素,并分析主要抗精神病用药的使用情况。结果105例精神分裂患者中,共30例患者合并糖尿病(28.6%),未合并糖尿病患者共75例(71.4%),其中,患者年龄≥45岁、病程≥15年及服用抗精神病药物是导致患者发生糖尿病的危险因素(P<0.05);治疗后,30例合并糖尿病患者中,服用氯氮平者空腹血糖、餐后2 h血糖及糖化血红蛋白值均高于服用利培酮等药物的患者(P<0.05)。结论经抗精神病药治疗引发糖尿病的精神分裂患者,主要与年龄、病程及具体服用的抗精神病药物有关,其中,氯氮平导致患者糖尿病的发生率最高,临床应根据患者具体情况选择性应用。

Objective To investigate the causes of diabetes mellitus induced by antipsychotics in treating patients with schizophrenia.Methods A total of 105 patients with schizophrenia were treated with antipsychotic drugs.The clinical data were analyzed.And the incidence of diabetes in schizophrenic patients and the relevant factors were collected.Logistic Regression Method was used to analyze the influencing factors relevant to diabetes induced by antipsychotics and the use of antipsychotic drugs.Results Of the 105 patients with schizophrenia,there were 30 patients(28.6%)with diabetes mellitus,and there were 75 patients(71.4%)without diabetes mellitus(28.6%).And the patient’s age(≥45 years),disease course(≥15 years)and the antipsychotic drugs administration were the risk factors of incidence of diabetes mellitus of patients with schizophrenia(P<0.05).After treatment,the levels of fasting blood glucose,postprandial 2 h blood glucose and glycosylated hemoglobin hose in the patients with diabetes mellitus who were treated by clozapine were significantly higher than those of patients who were treated by risperidone(P<0.05).Conclusion The diabetes mellitus induced by antipsychotic drugs in patients with schizophrenia is mainly related to patient’s age,disease course and the antipsychotic drugs administration.The incidence rate of diabetes mellitus caused by clozapine in patients with schizophrenia is the gighest,therfor,which should be used selectively according to the conditon of patients.