精神分裂症患者骨代谢的影响因素研究

Study of the factors influencing bone metabolism in patients with schizophrenia

目的:探索精神分裂症患者骨代谢的影响因素。方法:纳入88例精神分裂症患者(首发未用药精神分裂症患者21例,复发精神分裂症患者67例)和21名健康者为对照组,采用骨转换标志物作为评估精神分裂症患者骨代谢情况的依据。比较精神分裂症患者和健康对照组骨转换标志物水平的差异,了解精神分裂症患者的骨代谢情况;采用多元逐步回归分析探索精神分裂症患者骨代谢的影响因素。结果:精神分裂症患者与健康对照组相比骨形成标志物(骨源性碱性磷酸酶)显著降低,骨吸收标志物(β胶原降解产物)显著升高;多元逐步回归分析结果显示,年龄、性别、氯丙嗪等效剂量、病程、胰岛素和三酰甘油与精神分裂症患者的骨转换标志物存在相关性(P<0.05)。结论:精神分裂症患者存在骨代谢异常,年龄、性别、使用抗精神病药物、病程、胰岛素和三酰甘油可能是精神分裂症患者骨代谢的影响因素。

Objective:To explore the influencing factors of bone metabolism in patients with schizophrenia.Method:88 patients diagnosed with schizophrenia(21 unmedicated first-episode patients and 67 reccurent schizophrenia patients)and 21 healthy controls were enrolled.The bone turnover markers were used as the basis to evaluate the bone metabolism of patients with schizophrenia.The difference of bone turnover markers between schizophrenic patients and healthy controls was compared,and the bone metabolism of schizophrenia patients were analysed.Biochemical indexes and clinical characteristics related to bone metabolism were included in the regression equation,and multiple stepwise regression analysis was used to explore the influencing factors of bone metabolism in patients with schizophrenia.Results:Compared with healthy controls,the bone formation markers of schizophrenia patients was significantly lower,and the bone resorption markers(β-Crosslaps,β-CTx)was significantly higher.Multiple stepwise regression analysis showed that age,gender,chlorpromazine equivalents,course of disease,insulin and triacylglycerols(TG)were correlated with bone turnover markers in patients with schizophrenia(P<0.05).Conclusion:Patients with schizophrenia have abnormal bone metabolism.Age,gender,antipsychotics usage,course of disease,insulin and TG may be the influencing factors of bone metabolism in patients with schizophrenia.