住院患者第2代抗精神病药治疗相关迟发性运动障碍的危险因素

Risk factors for tardive dyskinesia with second-generation antipsychotics in inpatients

目的:探讨住院患者第2代抗精神病药治疗相关迟发性运动障碍的危险因素。方法:收集北京大学第六医院住院患者近10年资料,采用病例对照研究,纳入80例第2代抗精神病药治疗后出现迟发性运动障碍者为病例组,年龄、性别按1∶1匹配80例同时期无迟发性运动障碍患者为对照组,二分类Logistic回归分析发生迟发性运动障碍的危险因素。结果:多因素分析发现首次发病年龄(OR=6.00,95%CI:1.18~30.56)、初次用药年龄(OR=0.161,95%CI:0.03~0.83)、小学及以下文化者(OR=13.96,95%CI:1.07~172.17)、早期锥体外系反应(OR=12.30,95%CI:4.59~32.91)、应用利培酮(OR=4.01,95%CI:1.52~10.60)均是发生迟发性运动障碍的独立影响因素(P均<0.05)。结论:首次发病年龄大、初次用药年龄小、受教育程度低、早期锥体外系症状史、长期应用利培酮者可能是使用第2代抗精神病药期间易出现迟发性运动障碍的危险因素。

Objective:To analyze the risk factors for tardive dyskinesia(TD)with second-generation antipsychotics(SGAs).Method:The inpatients with TD from 2006 to 2016 in Peking University Sixth Hospital were collected.A case-control study were performed in 80 TD patients with second-generation antipsychotics and 80 age-and gender-matched control subjects during the same period according to a 1:1 ratio.Risk factors were analyzed by binary logistic regression.Results:Binary regression analysis showed that age of first onset(OR=6.00,95%CI:1.18-30.56),age of first medication(OR=0.161,95%CI:0.03-0.83),primary school education(OR=13.96,95%CI:1.07-172.17),early extrapyramidal symptoms(OR=12.30,95%CI:4.59-32.91)and long-term risperidone treatment(OR=4.01,95%CI:1.52-10.60)were independent influencing factors for TD(all P<0.05).Conclusion:Old age of first onset,young age of first medication,lower education level,early extrapyramidal symptoms and risperidone treatment are risk factors for TD when using second-generation antipsychotics.