长期住院精神分裂症患者空腹血糖及皮质醇水平对照研究

A comparative study on the levels of fasting blood glucose and cortisol in long-term hospitalized patients with schizophrenia

目的观察长期住院精神分裂症患者的血糖代谢情况以及应激指标变化。方法选取2019年1月至2020年12月上海市民政第一精神卫生中心收治的72例初次确诊且连续住院6个月以上的精神分裂症患者为研究对象,观察并记录患者初诊时、住院6个月后的空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、皮质醇(CO)水平,采用阳性与阴性精神症状(PANSS)量表评估患者病情,采用Pearson相关性分析血糖代谢、应激指标与患者病情变化之间的相关性。结果患者初诊时、住院6个月后的TC比较差异无统计学意义(P>0.05);住院6个月后,患者的TG、FBG及CO分别为(1.61±0.73)mmol/L、(5.94±1.25)mmol/L、(326.45±26.78)ng/mL,明显高于初诊时的(1.19±0.62)mmol/L、(5.13±1.18)mmol/L、(254.37±19.96)ng/mL,差异均有统计学意义(P<0.05);住院6个月后,患者的PANSS总分、阳性因子评分、阴性因子评分、一般精神病理评分分别为(88.12±10.23)分、(22.15±1.39)分、(20.87±1.76)分、(36.52±2.27)分,明显高于初诊时的(82.67±9.36)分、(18.92±2.44)分、(16.59±1.95)分、(31.61±1.73)分,差异均有统计学意义(P<0.05);患者PANSS总分、阳性因子评分、阴性因子评分、一般精神病理评分与TG、FBG及CO三项指标均呈正相关(P<0.05)。结论长期住院精神分裂症患者存在明显的糖代谢及皮质醇异常,提示临床需加强对患者血糖、皮质醇等指标的监测,并早期予以干预,以免进展为代谢综合征。

Objective To observe the changes of blood glucose metabolism and stress indexes in long-term hospitalized patients with schizophrenia.Methods A total of 72 patients with schizophrenia first diagnosed and hospitalized continuously for more than 6 months in Shanghai Civil Affairs First Mental Health Center were selected from January 2019 to December 2020.The levels of fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),and cortisol(CO)were observed and recorded at the first visit and 6 months after hospitalization.The condition of the patients was evaluated by positive and negative mental symptoms(PANSS)scale.Pearson correlation was used to analyze the correlation between blood glucose metabolism,stress index and the change of patient's condition.Results There was no significant difference in TC between the first visit and 6 months after hospitalization(P>0.05).After 6 months of hospitalization,the TG,FBG and CO of the patients were(1.61±0.73)mmol/L,(5.94±1.25)mmol/L and(326.45±26.78)ng/mL,respectively,which were significantly higher than(1.19±0.62)mmol/L,(5.13±1.18)mmol/L and(254.37±19.96)ng/mL at initial diagnosis(P<0.05).After 6 months of hospitalization,the total score of PANSS,positive factor,negative factor,and general psychopathological were(88.12±10.23)points,(22.15±1.39)points,(20.87±1.76)points,and(36.52±2.27)points,respectively,which were significantly higher than(82.67±9.36)points,(18.92±2.44)points,(16.59±1.95)points,and(31.61±1.73)points at the time of initial diagnosis(P<0.05).The total of PANSS score,positive factor,negative factor and general psychopathological were positively correlated with TG,FBG and CO(P<0.05).Conclusion There are significant abnormalities of glucose metabolism and cortisol in patients with schizophrenia in long-term hospitalization,suggesting that clinical monitoring of glucose,cortisol and other indicators of patients should be strengthened and early intervention should be performed,so as to avoid the progression of metabolic syndrome.