长期服用抗精神病药患者的肝脏超声状况及其相关因素

The status of abnormal liver ultrasound changes and its related factors in patients with long-term use of antipsychotic drugs

目的 分析长期服用抗精神病药的肝脏超声异常改变情况及其相关因素。方法 选取我院2018年5月~2022年11月期间长期服用(1年及以上)抗精神病药物的精神分裂症患者677例进行肝脏超声检查,根据肝脏结构是否改变分为肝脏结构正常组和异常组,收集两组临床相关治疗,采用多因素Logistic回归分析影响肝脏超声异常改变的因素。结果 677例长期服药的精神分裂症患者中,肝脏超声正常组有475例,占比70.16%,异常组202例,占比29.84%;两组间年龄、服药时间、服药类型、饮酒史、联合用药、腰围、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)对比有差异(P<0.05),其余对比无差异(P>0.05);多因素Logistic回归分析,显示年龄高(OR=1.066,95%CI=1.045~1.087)、体重指数高(OR=1.885,95%CI=0.790~0.990)、服药时间长(OR=1.532,95%CI=0.317~0.894)、联合用药(OR=1.393,95%CI=0.216~0.715)、有饮酒史(OR=2.026,95%CI=1.113~3.685)、TC高(OR=1.616,95%CI=0.434~0.872)、TG高(OR=1.023,95%CI=0.009~0.059)、LDL-C高(OR=1.183,95%CI=0.110~0.305)是肝脏超声发生异常改变的危险因素,服用典型抗精神病药(OR=0.900,95%CI=1.035~3.487)是肝脏超声发生异常改变的保护因素,腰围对肝脏异常改变无独立影响(P>0.05)。结论 长期服用抗精神病药会导致肝脏功能的异常改变,其中年龄高、服药时间长、服用非典型抗精神病药、体重指数高、联合用药、有饮酒史及TC、TG、LDL高是导致肝脏异常改变的危险因素。

Objective To analyze the abnormal changes in liver ultrasound and their related factors after longterm use of antipsychotic drugs.Methods 677 schizophrenic patients who took antipsychotic drugs for a long period of time(1 year or more)in our hospital from May 2018 to November 2022 were selected for liver ultrasound examination.They were divided into normal and abnormal liver structure groups based on whether the liver structure had changed.Clinical related treatments were collected from two groups,and the factors affecting abnormal liver ultrasound changes were analyzed using multivariate logistic regression.Results Among the 677 long-term medication taking schizophrenia patients,there were 475 cases in the normal liver ultrasound group,accounting for 70.16%,and 202 cases in the abnormal liver ultrasound group,accounting for 29.84%.There were differences in age,medication duration,medication type,alcohol consumption history,combination medication,waist circumference,TC,TG,and LDL-C between the two groups(P<0.05),while there were no differences in other comparisons(P>0.05).Multivariate logistic regression analysis showed high age(OR=1.066,95% CI=1.045-1.087),high body mass index(OR=1.885,95% CI=0.790-0.990),long medication duration(OR=1.532,95% CI=0.317-0.894),combination medication(OR=1.393,95% CI=0.216-0.715),history of alcohol consumption(OR=2.026,95% CI=1.113-3.685),high TC(OR=1.616,95% CI=0.434-0.872),high TG(OR=1.023,95% CI=0.009-0.059) High LDL-C(OR=1.183,95% CI=0.110~0.305) is a risk factor for abnormal liver ultrasound changes,while taking typical antipsychotic drugs(OR=0.900,95% CI=1.035~3.487) is a protective factor for abnormal liver ultrasound changes.Waist circumference has no independent effect on abnormal liver changes(P>0.05).Conclusion Long term use of antipsychotic drugs can lead to abnormal changes in liver function,among which older age,longer medication duration,use of atypical antipsychotic drugs,higher body mass index,combination medication,history of alcohol consumption,and high TC,TG,and LDL are risk factors for abnormal liver changes.