精神分裂症首发患者治疗后体质量增加的影响因素分析

Analysis of influencing factors of body weight gain in first-episode patients with schizophrenia after treatment

目的 探讨精神分裂症(schizophrenia,SCH)首发患者利培酮单药治疗后体质量增加的影响因素。方法选取2015年1月至2018年12月北京回龙观医院SCH首发患者123例,给予利培酮单药治疗(4~6 mg/d)12周,以12周末体质量较基线增加7%为界,分为非体质量增加组(82例)和体质量增加组(41例)。采用多因素logistic回归方程分析SCH首发患者治疗后体质量增加的影响因素。结果 123例患者中男55例,女68例,年龄18~55岁,平均(28.8±9.6)岁。治疗12周后,33.33%的SCH首发患者体质量增加。与非体质量增加组相比,体质量增加组的基线体质量、BMI和TG较低[(55.74±9.99)kg比(63.27±13.00)kg、(20.02±3.14)kg/m^(2)比(23.03±3.86)kg/m^(2)和(0.95±0.42)mmol/L比(1.19±0.57)mmol/L],差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,基线BMI越低(OR=0.729,95%CI:0.574~0.926,P=0.010)的SCH首发患者,发生体质量增加的风险越高。结论 基线BMI水平越低的SCH首发患者,利培酮治疗后体质量增加的概率越高。建议基础BMI较低的SCH首发患者选用不增加体质量或者对于体质量影响小的治疗药物。

Objective To explore the influencing factors of weight gain in first-episode patients with schizophrenia(SCH) after treatment.Methods A total of 123 first-episode SCH patients in Beijing Huilongguan Hospital from January 2015 to December 2018 were selected.The patients were treated with risperidone monotherapy(4-6 mg/d) for 12 weeks,and were divided into non-weight gain group(82 cases) and weight gain group(41 cases) based on the 7% increase in weight at the end of 12 weeks compared with the baseline.Multivariate logistic regression was used to analyze the influencing factors of body weight gain in the first-episode SCH patitents after treatment.Results Among 123 patients,there were 55males and 68 females,aged from 18 to 55 years,with an average age of(28.8 ± 9.6) years.The detection rate of weight gain was 33.33% after 12 weeks of treatment.The baseline weight,BMI and TG in the weight gain group were lower than those in the non-weight gain group [(55.74 ± 9.99) kg vs.(63.27 ± 13.00) kg,(20.02 ± 3.14) kg/m^(2) vs.(23.03 ± 3.86) kg/m^(2),(0.95 ±0.42) mmol/L vs.(1.19 ± 0.57) mmol/L],and the differences were statistically significant(all P<0.05).Multivariate logistic regression analysis results showed that the lower the baseline BMI(OR = 0.729,95%CI:0.574-0.926,P = 0.010),the higher the risk of weight gain for first-episode SCH patients.Conclusions The lower the baseline BMI,the higher the probability of weight gain after risperidone treatment.It is suggested that the first-episode SCH patients with a lower baseline BMI should choose therapeutic drugs that do not increase weight or have little impact on weight.