社区重症精神疾病患者共病心血管疾病的现状及危险因素

Prevalence and risk factors of cardiovascular disease in patients with serious mental disorders in community

目的:探讨社区重症精神疾病(SMI)患者共病心血管疾病的现状及其危险因素。方法:随机抽取北京市朝阳区内的4个社区,采集已建档立卡的SMI患者一般人口学资料,采用自制心血管疾病调查问卷调查心血管疾病如高血压、冠心病、心律失常和心绞痛等患病情况。结果:481例SMI患者入组,其中122例(25.4%)共病心血管疾病,其中22.0%共病高血压,1.7%共病心绞痛,1.5%共病心肌梗死,共病心肌炎和心肌病各0.4%,具有诊断意义的心电图异常(包括QTc延长)为9.1%;多因素Logistic回归分析显示,血脂异常(OR=6.387)、吸烟史(OR=2.723)、服用≥2种抗精神病药(OR=2.160)、BMI高(OR=1.137)、年龄大(OR=1.026)是社区SMI患者共病心血管疾病的独立危险因素。结论:社区SMI患者共患心血管疾病高;其高血脂、吸烟、服用≥2种抗精神药、肥胖及年龄大是共病心血管疾病的危险因素。

Objective:To explore the current situation of cardiovascular disease in patients with serious mental illness(SMI)in community and to analyze the related factors.Method:The cross-sectional population-based study was conducted in Beijing,four communities were randomly selected from Chaoyang District and 481 patients with severe mental illness information system were selected and followed up.General demographic data were collected and self-made investigation of cardiovascular diseases such as hypertension,coronary heart disease,arrhythmia and angina pectoris were investigated.Results:Of the 481 patients with chronic SMI,122 had cardiovascular disease,accounting for 25.4 percent.Hypertension accounted for 22.0%,angina pectoris 1.7%,myocardial infarction 1.5%,myocarditis 0.4%and cardiomyopathy 0.40.The diagnostic ECG abnormality(including prolonged QTc)accounted for 9.1%.Multivariate Lofistic regression analysis showed that dyslipidemia(OR=6.387),smoking history(OR=2.723),taking more than two antipsychotics(OR=2.16),high body mass index(OR=1.137),and older age(OR=1.026)were independent risk factors for cardiovascular disease in patients with SMI in community.Conclusion:Patients with SMI in community have a high incidence of cardiovascular disease;It suggests that high cholesterol,smoking history,taking more than two antipsychotics,obesity and old age may contribute to occurrence of SMI comorbid cardiovascular disease in community.