精神分裂症患者发生代谢综合征及心血管疾病的风险因素研究

Study on risk factors of metabolic syndrome and cardiovascular disease in schizophrenic patients

目的 探讨精神分裂症患者发生代谢综合征(MS)及心血管疾病的风险因素。方法 选取60例男性精神分裂症患者为研究对象进行回顾性分析,根据MS诊断结果分为MS组(25例)与非MS组(35例),进行精神分裂症患者发生MS的单因素、多因素Logistic回归分析;分析弗雷明汉风险评分(FRS评分)与心血管疾病高风险因素的相关性。结果 MS组患者年龄(48.60±7.77)岁、空腹血糖(FPG)(5.98±1.33)mmol/L、低密度脂蛋白胆固醇(LDL-C)(2.82±0.34)mmol/L、载脂蛋白B(ApoB)(1.11±0.17)g/L、FRS评分(6.21±1.99)分均高于非MS组的(41.86±9.64)岁、(5.04±1.37)mmol/L、(2.42±0.25)mmol/L、(0.99±0.08)g/L、(4.86±0.63)分,高密度脂蛋白胆固醇(HDL-C)(1.11±0.17)mmol/L低于非MS组的(1.26±0.23)mmol/L,差异有统计学意义(P<0.05)。非MS组与MS组患者的总胆固醇(TC)、载脂蛋白A(ApoA)、收缩压、舒张压、餐后2 h血糖、吸烟史对比无差异(P>0.05)。将单因素分析中P<0.05的因素纳入Logistic回归模型做进一步分析, FRS评分高是精神分裂症患者发生MS的独立危险因素[OR=59.814, 95%CI=(1.421, 2518.103), P<0.05]。Pearson相关分析显示, TC、ApoB、收缩压、舒张压、FPG、餐后2 h血糖与FRS评分呈正相关(r=0.391、0.444、0.352、0.591、0.739、0.560, P<0.05)。结论 FRS评分高为精神分裂症患者发生MS的独立危险因素, TC、ApoB、血压、血糖均为心血管疾病发病的正向关联因素,对高危风险因素的发现有助于精神分裂症患者早期预防心血管疾病及MS。

Objective To explore the risk factors of metabolic syndrome(MS)and cardiovascular disease in schizophrenic patients.Methods 60 male schizophrenic patients were selected for retrospective analysis and divided into MS group(25 patients)and non-MS group(35 patients)according to MS diagnosis.Univariate and multivariate Logistic regression analysis of the occurrence of MS in patients with schizophrenia were performed to analyze the correlation between Framingham risk score(FRS)and cardiovascular disease risk factors.Results In MS group,the age was(48.60±7.77)years,the fasting plasma glucose(FPG)was(5.98±1.33)mmol/L,the low-density lipoprotein cholesterol(LDL-C)was(2.82±0.34)mmol/L,the apolipoprotein B(ApoB)was(1.11±0.17)g/L,and FRS score was(6.21±1.99)points,which were higher than(41.86±9.64)years,(5.04±1.37)mmol/L,(2.42±0.25)mmol/L,(0.99±0.08)g/L,and(4.86±0.63)points in non-MS group;the high-density lipoprotein cholesterol(HDL-C)of(1.11±0.17)mmol/L in MS group was lower than(1.26±0.23)mmol/L in non-MS group;the difference was statistically significant(P<0.05).There was no difference in total cholesterol(TC),apolipoprotein A(ApoA),systolic blood pressure,diastolic blood pressure,2 h postprandial glucose,and smoking history between non-MS group and MS group(P>0.05).Factors with P<0.05 in univariate analysis were incorporated into Logistic regression model for further analysis,and high FRS score was an independent risk factor for MS in schizophrenia patients[OR=59.814;95%CI=(1.421,2518.103);P<0.05].Pearson correlation analysis showed that TC,ApoB,systolic blood pressure,diastolic blood pressure,FPG,2 h postmeal blood glucose were positively correlated with FRS score(r=0.391,0.444,0.352,0.591,0.739,0.560;P<0.05).Conclusion High FRS score is an independent risk factor for the development of MS in schizophrenic patients,and TC,ApoB,blood pressure,and blood glucose are all positive correlates of the development of cardiovascular disease,and the discovery of high-risk risk factors can help in the early prevention of cardiovascular disease and MS in schizophrenic patients.