精神分裂症住院患者糖脂代谢紊乱高危因素分析及防护对策

Analysis of high-risk factors of glucose and lipid metabolism disorders in inpatients with schizophrenia and relevant protective countermeasures

目的探讨精神分裂症住院患者体糖脂代谢紊乱高危因素及防护对策。方法选取2016年8月—2020年6月医院精神科接受住院治疗的精神分裂症患者365例作为研究对象,住院期糖脂代谢紊乱发生例数为56例。观察收集患者性别、年龄、精神疾病家族史、婚姻状况、长期吸烟、住院时间≥35d、基础疾病、住院季节、联用抗精神病药物种类、二甲双胍使用、Hcy水平、血红蛋白水平、白蛋白水平等指标信息,对可能影响精神分裂症住院患者糖脂代谢紊乱的相关因素采取单因素和多因素Logistic回归分析。结果经过单因素及多因素分析,年龄≥60岁、长期吸烟、Hcy水平、抗精神病药物>2种是影响糖脂代谢紊乱的独立因素(P<0.05);二甲双胍使用是降低糖脂代谢紊乱风险的独立保护因素(P<0.05)。结论针对导致精神分裂症住院患者糖脂代谢紊乱的年龄≥60岁、长期吸烟、Hcy水平、两种抗精神病药物联用、二甲双胍使用等因素,护理人员应及早预测,尽早实施干预措施,降低糖脂代谢紊乱发生概率。

Objective To explore the high-risk factors of glucose and lipid metabolism disorders in inpatients with schizophrenia and relevant protective countermeasures.Methods To select 365 cases of patients with schizophrenia who were hospitalized in the psychiatric department of a hospital from August 2016 to June 2020 as the study objects,and the number of cases of glucose and lipid metabolism disorders during the hospitalization period was 56 cases.The patients’indexes information such as gender,age,family history of mental illness,marital status,long-term smoking,hospitalization time≥35 days,underlying disease,hospitalization season,type of combined antipsychotic drugs,metformin use,Hcy level,hemoglobin level,albumin level and so on,were observed and collected,and single factors and multivariate Logistic regression analysis were used to analyze the related factors that may affect the glucose and lipid metabolism disorder of schizophrenia inpatients.Results Univariate analysis and multivariate analysis showed that the age≥60 years old,long-term smoking,level of Hcy and>2 kinds of antipsychotic drugs were the independent factors aff ecting glucose and lipid metabolism disorders(P<0.05).The use of metformin was the independent protective factor to reduce the risk of glucose and lipid metabolism disorders(P<0.05).Conclusion In view of factors such as age≥60 years old,long-term smoking,Hcy level,combination of two antipsychotic drugs,and metformin use that lead to disorders of glucose and lipid metabolism in hospitalized patients with schizophrenia,nursing staff should predict and implement intervention measures as soon as possible to reduce the probability of glucose and lipid metabolism disorders.