Effects of different doses of metformin on bone mineral density and bone metabolism in elderly male patients with type 2 diabetes mellitus

BACKGROUND Diabetes is a chronic disease,which may cause various complications.Patients with diabetes are at high risk of bone and joint disorders,such as osteoporosis and bone fractures.In addition,it became widely accepted that diabetes has an important impact on bone metabolism.Metformin is a commonly used and effective first-line treatment for type 2 diabetes.Some glucose-lowering agents have been found to have an effect on bone metabolism.The present study explored if different doses of metformin have an effect on bone mineral density(BMD)and bone metabolism in type 2 diabetes.AIM To investigate the effects of different doses of metformin on BMD and bone metabolism in elderly male patients with type 2 diabetes mellitus.METHODS A total of 120 elderly male outpatients with type 2 diabetes mellitus who were admitted to our hospital were included in the study from July 2018 to June 2019.They were randomly assigned to an experimental group and a control group with 60 patients in each group.Patients in the experimental group were given high dose metformin four times a day 0.5 g each time for 12 wk.Patients in the control group were given low dose metformin orally twice a day 0.5 g each time for 12 wk.The changes in bone mineral density and bone metabolism before and after treatment and the efficacy rate of the treatment were compared between the two groups.RESULTS There was no significant difference in the efficacy rate between the two groups(P>0.05).Before the treatment,there was no significant difference in BMD and bone metabolism between the two groups(P>0.05).However,after the treatment,BMD and bone metabolism were improved in the two groups.Moreover,BMD and 25-hydroxyvitamin D were significantly higher in the experimental group than in the control group,and N-terminal/midregion andβ-isomerized Cterminal telopeptides were significantly lower in the experimental group than in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION Both high and low dose metformin can effectively control the blood glucose levels in elderly male patients with type 2 diabetes mellitus.However,the benefits of high dose metformin in improving BMD and bone metabolism level was more obvious in patients with type 2 diabetes mellitus.

Central Venous Catheter-related Thrombosis in Senile Male Patients: New Risk Factors and Predictors

Central venous catheterization（CVC）-related venous thrombosis is a common but serious clinical complication, thus prevention and treatment on this problem should be extensively investigated. In this research, we aimed to investigate the incidence rate of CVC-related venous thrombosis in senile patients and give a further discussion on the related risk factors and predictors. A total of 324 hospitalized senile male patients subjected to CVC were selected. Retrospective investigation and analysis were conducted on age, underlying diseases, clinical medications, catheterization position and side, catheter retention time, and incidence of CVC-related venous thrombosis complications. Basic laboratory test results during catheterization and thrombogenesis were also collected and analyzed. Among the 324 patients, 20 cases（6.17%） of CVC-related venous thrombosis were diagnoseds. The incidence rate of CVC-related venous thrombosis in subclavian vein catheterization was significantly lower than that in femoral vein catheterization（P〈0.01） and that in internal jugular vein catheterization（P〈0.05）. No statistically significant difference was found between femoral vein catheterization and internal jugular vein catheterization（P〉0.05）. Previous venous thrombosis history（P〈0.01）, high lactate dehydrogenase level（P〈0.01）, low high-density lipoprotein（HDL） level（P〈0.05）, and low albumin level（P〈0.05） were found as risk factors or predictors of CVC-related venous thrombosis in senile male patients. Subclavian vein catheterization was the most appropriate choice among senile patients to decrease the incidence of CVC-related venous thrombosis. Previous venous thrombosis history, high lactate dehydrogenase level, low HDL level, and low albumin level were important risk factors in predicting CVC-related venous thrombosis.

Choroidal vascular occlusion in a young male patient with sickle cell trait

Dear Editor,Choroidal vascular occlusion is a rare finding. Choroidal perfusion disorders may range from focal infarction of the choriocapillaris to fibrinoid arteriolar necrosis. Vascular occlusion due to microembolism is more common in choroidal than in retinal vasculature. Due to its unique hemodynamic characteristics, which involve one of the highest rates of blood flow in the body and the fact that it is functionally an end artery system, the choroidal circulation is prone to platelet emboli associated with cardiovascular disease and other pathologies with increased risk of microembolismt.

Clinical outcomes of COVID-19 in elderly male patients

Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)has spread throughout the world involving more than 200 countries with more than 3 million confirmed cases and over 200,000 deaths worldwide.[1]COVID-19 patients primarily present with respiratory symptoms showing abnormal lung changes on chest X-ray or computed tomography(CT)with typical imaging appearances of ground glass opacities and consolidation.

Analysis of semen quality of 38 905 infertile male patients during 2008- 2016 in Wenzhou, China

This study analyzed the trend in semen quality of infertile male patients in Wenzhou,China,based on the data obtained from 38905 patients during 2008-2016 in The First Affiliated Hospital of Wenzhou Medical University(Wenzhou,China).The results showed that only 24.9%of the patients had normal semen quality.For the semen quality of infertile male patients,that of the workers and 40-year-olds was significantly worse than the other occupational and age groups.For all the infertile patients,low semen volume,asthenozoospermia,and teratozoospermia accounted for 8.4%,50.5%,and 54.1%,respectively.During 2008-2016,the annual mean percentage of fast forward motile spermatozoa,percentage of total forward motile spermatozoa,and percentage of spermatozoa with normal morphology decreased linearly with slopes of-2.11,-2.59,and-0.70,respectively.The proportion of patients with asthenozoospermia and multi-abnormal spermatozoa increased during 2008-2016 with slopes of 4.70 and 4.87,respectively,while for low semen volume,it decreased with a slope of-0.47 in the same time period.The proportion of patients with teratozoospermia increased from 2008 to 2011 and from 2011 to 2016 with slopes of 17.10 and 2.09,respectively.In general,the deteriorating trend of semen quality of infertile male patients in Wenzhou was obvious.Future efforts should be made to reveal the adverse influences on semen quality,such as occupational exposure,environmental quality,and living habits.Furthermore,more pervasive reproduction health education is necessary.

Elevation of serum NT-proBNP level-A possible biomarker of malnutritiion in an elderly male patient

INTRODUCTION B-type natriuretic peptide （BNP） is a 32- amino acid polypeptide secreted by ventricular myocytes during period of increased ventricu- lar stretch and wall tension. It is believed that the peptide plays an important role in the reg- ulation of blood pressure, blood volume, and sodium balance. Because in vitro studies have reported that natriuretic peptides are directly released from cardiomyocytes in response to myocardial ischemia , it has been proposed that their circulating levels are relevant to sub- sequent risk of cardiovascular diseases （CVDs） other than heart failure.

Epidemiology of Male Sexual Dysfunction (MSD) in Patients Consulting in Some Health Services in the City of Douala, Cameroon

Sexual dysfunction is a group of diseases, disorders or difficulties experienced by men or women during any stage of normal sexual activity. In Africa in general and Cameroon in particular, statistical data concerning the prevelance and the main causes of male sexual dysfunction are rare due to socio-cultural and religious burdens and sometimes self-medication. The objective of this work was to determine the prevalences, comorbidities and the risk factors of the main sexual dysfunction in some hospitals in city of Douala. Through a descriptive retrospective study carried out from Novembre 2019 to June 2021, sociodemographic parameter, reasons of consultation, risk factors and type of male sexual dysfunction (erectile dysfunction or erectile dysfunction (ED), ejaculation disorders (EjD), libido disorders (LD) and disorders of sexual activity with pain or painful sexual intercourse (PSI)) were collected in the medical files of patients who have made urological consultation between 2016 and 2020 at the Deido District hospital, Laquintinie Douala Hospital and Douala General hospital respectively. At the end of our data collection, out of a total of 24995 consultations, 2743 (10.98%) patients were suffering from at least one male sexual dysfunction. Moreover, sexual disorders were the 2nd reason of urological consultation (13.69%) after urinary disorders (33.85%). Among sexual disorders, erectile (76%) and ejaculatory (20%) disorders were the predominant pathologies recorded with the prevalences of 9.79 et 2.62% respectively, and were mostly represented in patients from [41 - 50] for erectile dysfunction, and [18 - 30] years old for ejaculative dysfunction. In addition, the number of patients with ejaculatory and erectile dysfunctions was more important in patients from [18 - 30] and [31 - 40] years old respectively. Among patients presenting sexual disorders, several risk factors or pathologies were associated with the dysfunction: benign prostatic hyperplasia and metabolic syndrome (in patients over 50 years old);psychosocial problems, infections, and alcohol (in patients under 50 years old). These findings could be useful in the elaboration of therapeutic strategies for the management of the Cameroonian population suffering from sexual dysfunctions.

Long term recurrence,pain and patient satisfaction after ventral hernia mesh repair

AIM: To compare long term outcomes of laparoscopic and open ventral hernia mesh repair with respect to recurrence, pain and satisfaction.METHODS: We conducted a single-centre follow-up study of 194 consecutive patients after laparoscopic and open ventral hernia mesh repair between March 2000 and June 2010. Of these, 27 patients(13.9%) died and 12(6.2%) failed to attend their follow-up appointment. One hundred and fifty-three(78.9%) patients attended for follow-up and two patients(1.0%) were interviewed by telephone. Of those who attended the follow-up appointment, 82(52.9%) patients had received laparoscopic ventral hernia mesh repair(LVHR) while 73(47.1%) patients had undergone open ventral hernia mesh repair(OVHR), including 11 conversions. The follow-up study included analyses of medical records, clinical interviews, examination of hernia recurrence and assessment of pain using a 100 mm visual analogue scale(VAS) ruler anchored by word descriptors. Overall patient satisfaction was also determined. Patients with signs of recurrence were examined by magnetic resonance imaging or computed tomography scan.RESULTS: Median time from hernia mesh repair to follow-up was 48 and 52 mo after LVHR and OVHR respectively. Overall recurrence rates were 17.1% after LVHR and 23.3% after OVHR. Recurrence after LVHR was associated with higher body mass index. Smoking was associated with recurrence after OVHR. Chronic pain(VAS > 30 mm) was reported by 23.5% in the laparoscopic cohort and by 27.8% in the open surgery cohort. Recurrence and late complications were predictors of chronic pain after LVHR. Smoking was associated with chronic pain after OVHR. Sixty point five percent were satisfied with the outcome after LVHR and 49.3% after OVHR. Predictors for satisfaction were absence of chronic pain and recurrence. Old age and short time to follow-up also predicted satisfaction after LVHR.CONCLUSION: LVHR and OVHR give similar long term results for recurrence, pain and overall satisfaction. Chronic pain is frequent and is therefore important for explaining dissatisfaction.

育龄期男性癌症患者生育忧虑的现状及影响因素分析

目的探索育龄期男性癌症患者生育忧虑现状,并探索相关的影响因素。方法采用一般资料调查表、育龄期男性癌后生育忧虑量表及社会支持量表于2022年10月至12月对四川省某3所三级甲等医院389名育龄期男性癌症患者进行调查分析。结果389名育龄期男性癌症患者的生育忧虑得分为(59.99±6.59)分,患者的婚姻状况、家庭经济水平、子女个数、生育意愿、癌症类型、社会支持及病耻感水平是患者生育忧虑的影响因素,能够解释总变异的72.7%。结论育龄期男性癌症患者生育忧虑水平中等偏高,应关注未婚、离异、家庭经济水平较差、无子女、有生育意愿、罹患生殖系统癌症、社会支持水平较差及病耻感水平较高的患者,为患者提供专业的信息支持,并采取适当的措施缓解其生育忧虑。

人工牛黄甲硝唑胶囊致男性患者外生殖器多形红斑型药疹的诊疗分析

目的:分析1例人工牛黄甲硝唑胶囊致男性患者外生殖器多形红斑型药疹的诊疗过程,为临床该药的用药安全提供参考。方法与结果:该患者因牙痛而自行购买人工牛黄甲硝唑胶囊服用,但第2天患者发现外生殖器不行米粒至豆粒大小的红斑,呈密集对称分布,伴轻微瘙痒,遂自行停药;但停药多日后仍未见好转,皮损还逐渐增大,且表面出现糜烂、渗出,遂入院治疗;入院后,对患者予以了抗炎、抗感染治疗,2周后患者红斑基本消失,1个月后患者皮损也基本痊愈;其间,医生采用诺氏评估量表考察多形红斑型药疹与人工牛黄甲硝唑胶囊的关联性,结果评分为6分,即关联性为“很可能”。结论:人工牛黄甲硝唑胶囊所致药疹仅出现在外生殖器部位而未涉及身体其他部位的情况较为罕见,临床在宣教时应做好用药交代,以便于患者早分辨、早治疗。

男性尿道狭窄患者行尿道成形术治疗期间疾病体验的质性研究

目的 深入了解男性尿道狭窄患者行尿道成形术治疗期间的患病体验和心理感受。方法 采用质性研究中描述性现象学研究法,于2022年11月-2023年1月对13例上海市某三级甲等综合医院泌尿外科尿道狭窄患者进行深入访谈,借助Nvivo 11.0软件管理访谈资料,采用Colaizzi 7步分析法进行归纳分析并提炼主题。结果 共提炼出4个主题及9个亚主题:不良生理体验(排尿方式改变的不适、疼痛)、消极心理感知(遗憾和不满、对预后不确定的担忧)、面临诸多困境(求医历程曲折、夫妻关系破裂、频繁诊治与工作的矛盾)、需求与希望(对最佳医疗条件的需求、希望获得多层次信息支持)。结论 尿道狭窄患者行尿道成形术治疗期间面临多方面的困扰,医护人员应重视患者的不良反应和内心需求,加强健康照护、提供信息支持和情感引导,促进家庭关系和谐,改善患者的身心健康。

男性酒精依赖病人发生抑郁症的风险预警模型构建与验证

目的:探讨男性酒精依赖病人发生抑郁症的影响因素,基于独立危险因素构建并验证风险预警模型。方法:选取2021年3月—2022年9月在医院就诊的128例男性酒精依赖病人,将128例病人按7∶3分为建模集(n=90)和验证集(n=38),根据建模集中病人有无发生抑郁症分为抑郁组(n=44)和正常组(n=46),通过单因素及多因素Logistic回归分析得出独立危险因素,并基于回归分析法构建风险预警模型,使用R语言软件绘制相应的列线图,采用受试者工作特征(receiver operating characteristic,ROC)曲线、校准曲线检验预测效能。采用验证集的数据绘制2种曲线对模型的预警效能进行外部验证。结果:单因素及多因素Logistic回归分析结果显示,累计饮酒年限、就业情况、抑郁症家族史、儿时创伤事件、睡眠质量指数和合并糖尿病均与发生抑郁症有关(P<0.05),基于以上6个独立危险因素构建的风险预警模型其曲线下面积(area under curve,AUC)为0.854,最佳截断值0.603对应的灵敏度、特异度分别为0.727,0.870,校准曲线结果显示,平均绝对误差(mean absolute error,MAE)为0.036,模型预测概率与实际发生的概率之间差异不大,具备较好的预测准确性。验证集结果显示模型外部预测性能良好。结论:男性酒精依赖病人发生抑郁症受累计饮酒年限、就业情况、抑郁症家族史等因素影响,基于各独立危险因素构建的风险预警模型预测性能良好,可为男性酒精依赖病人给予心理疏导方案制订预防抑郁症提供参考。

云南省勐腊县2019—2022年性病/艾滋病哨点男性就诊者监测结果分析

目的 了解云南省勐腊县性病门诊男性就诊者艾滋病、梅毒及丙肝的流行情况,为制定艾滋病防控政策提供参考。方法 依据《全国艾滋病哨点监测实施方案》,通过连续抽样的方法,对监测期内前往性病门诊哨点就诊的男性就诊者开展问卷调查和血清学检查。结果 2019—2022年共监测659例就诊者,其中HIV阳性有7人(1.06%)、梅毒阳性有44人(6.68%)、HCV阳性有4人(0.61%)。2019—2022年,最近3个月内发生过商业性行为的比例呈线性下降趋势,最近3个月内与临时性伴发生过性行为的比例则无变化趋势。结论 性病门诊男性就诊者是艾滋病、性病防治工作中需要重点关注的人群,应加强性病门诊监测,做好艾滋病等性传播疾病的筛查,加强重点人群的健康教育和高危行为干预,降低性传播疾病的蔓延。

泌尿外科住院老年男性肾结石合并尿路感染患者病原微生物检验结果及耐药性分析

目的探讨分析泌尿外科住院老年男性肾结石合并尿路感染患者病原微生物检验结果及耐药性。方法将新沂市人民医院2023年1月至2023年12月期间收治的住院老年男性肾结石合并尿路感染患者172例纳入研究,搜集所有患者的尿液样本,并进行病原微生物检验及耐药性分析。结果172例患者共检出病原菌172株,主要病原菌分类为革兰阴性菌、革兰阳性菌及真菌,占比分别为63.37%、22.09%、14.53%。大肠埃希菌对头孢呋辛酯、环丙沙星、左氧氟沙星的耐药性最强;肺炎克雷伯菌对头孢呋辛酯、头孢他啶的耐药性最强;肠球菌属对红霉素耐药性最强;凝固酶阴性葡萄球菌对红霉素的耐药性最强。结论住院老年男性肾结石合并尿路感染患者尿液样本中的病原菌分布广泛,其中以革兰阴性菌占比最高,且耐药性最强。

育龄男性癌症患者生育力保护知识及需求调查

目的了解育龄男性癌症患者对于生育力保护的知识水平及生育力保护需求现况。方法采用自制的育龄男性癌症患者生育力保护知识水平及需求调查问卷对332例育龄男性癌症患者进行横断面调查。结果男性癌症患者生育力保护知识得分(3. 5±0. 7)分。77. 71%患者意识到癌症治疗会损害生育能力,63. 86%和80. 72%患者不知晓生育力保护的常规方法及场所。仅10. 54%患者在肿瘤治疗前选择精子库进行生育力保存,有68. 67%患者在治疗过程中希望进行生育力保存。多因素Logistic回归分析结果显示,家庭月收入、年龄是患者生育力保护知识水平的影响因素(均P <0. 05);年龄、有无子女是患者生育力保护需求的影响因素(均P <0. 05)。结论育龄男性癌症患者对生育力保护的知识水平不高,多数患者在治疗前并未选择生育力保护措施,但是在治疗期间有生育力保护的需求。年轻及家庭月收入≥8 000元的患者具备更多生育力保护知识。年轻及无子女的患者在治疗过程中有生育力保存的需求。医务人员需要在患者进行治疗前充分告知生育力保护的相关信息,全面评估患者对信息的掌握程度,为患者提供切实可行的生育力保护措施和指导。

男性原发性骨质疏松肾虚三证与血液流变学变化关系的临床研究

目的 探讨男性原发性骨质疏松 (primary osteoporosis:POP)肾虚三证与血液流变学变化的关系为临床辨证施治提供客观诊断依据。方法 选择 96例有肾虚见证的老年男性为研究对象 ,其中肾气虚 36例 ,肾阴虚 32例 ,肾阳虚2 8例 ,另选正常对对照组 30例 ,同步检测全血粘度ηb、(高切 )、血浆粘度ηp、血沉 SR、红细胞压积 HCT,并进行统计学分析。结果 与对照组相比 ,肾虚三型全血粘度、血浆粘度显著增高 (P<0 .0 1) ,肾阳虚证的血沉值、红细胞压积显著上升 (P<0 .0 5 ) ,其余两型升高无显著性 ,肾气虚、肾阳虚、肾阴虚三个证型的ηb、ηp、SR、HCT水平组间差异不显著 (P>0 .0 5 ) ,结论 1男性 POP肾虚三证患者ηb、ηp的含量较对照组显著升高。2男性 POP患者血液粘、凝状态变化与肾虚三证关系密切 ,其变化依肾阴虚、肾气虚、肾阳虚逐渐明显。 3本研究揭示血液流变学水平变化可作为判断男性 POP肾虚三型的客观指标 ,活血化瘀应作为治疗 POP的基本方法。

脉搏灌注指数在评估老年男性患者低位硬膜外麻醉阻滞效果中的应用

目的:评估脉搏灌注指数(pulse oximeter perfusion index,PI)在判断老年男性患者低位硬膜外麻醉阻滞效果中的应用。方法:66例美国麻醉医师协会(American Society of Anesthesiologists,ASA)Ⅰ~Ⅲ级、年龄≥60岁的男性患者经硬膜外导管给予2%利多卡因后观察30 min,记录针刺皮肤测痛时双侧脚趾PI、针刺皮肤测痛时痛觉的变化以及提睾反射消失的时间。PI的变化率≥100%、痛觉及提睾反射消失考虑硬膜外麻醉阻滞有效。不同时刻PI的比较使用单因素重复测量方差分析,PI与提睾反射及针刺皮肤测痛预测硬膜外麻醉的成功率在各时刻点的比较使用配对四格表资料的卡方检验。结果:硬膜外腔给药后2 min PI逐渐增加,4 min痛觉开始减退,20 min提睾反射开始消失。在硬膜外腔给药后10、20及30 min各时刻点所有患者的PI均增加100%(P=0.000),针刺皮肤测痛的结果是0/66、45/66(χ2=24.973,P=0.000)、66/66,提睾反射消失的结果是0/66、51/66(χ2=16.923,P=0.000)、66/66。结论:PI是评估老年男性患者低位硬膜外麻醉阻滞效果的早期、客观指标。

术前不同方式和时机导尿对全麻男性患者舒适度的影响

目的探讨不同方式和时机导尿对全麻男性患者舒适度的影响。方法 300例择期行全麻手术的男性患者,随机分为3组,每组100例。Ⅰ组:全麻诱导前用硅油涂尿管行导尿术;Ⅱ组:全麻诱导后用硅油涂尿管行导尿术;Ⅲ组:全麻诱导后用复方利多卡因乳膏涂尿管行导尿术。观察并比较三组患者导尿术前、中、后的血压、心率变化;对麻醉苏醒期患者进行与导尿舒适度和效果紧密相关的躁动综合评分(RS评分),并比较评分的组间差异情况。结果Ⅰ组导尿术中、术后血压、心率比术前明显升高,差异有统计学意义(P<0.05),而Ⅱ、Ⅲ组与术前比较差异无统计学意义(P>0.05)。与Ⅰ组比较,Ⅱ组RS评分显著升高,差异有统计学意义(P<0.05);而Ⅲ组RS评分与Ⅰ组比较,差异无统计学意义(P>0.05)。结论全麻诱导后用复方利多卡因乳膏导尿(Ⅲ组)能减少患者因隐私暴露、疼痛不适导致血压、心率升高,且对降低男性患者苏醒期躁动。

男性精神障碍患者肇事肇祸行为相关因素研究

背景少数精神障碍患者的攻击行为容易演变为肇事肇祸行为,以男性患者为主,目前缺乏对该类患者发生肇事肇祸行为相关因素的分析研究。目的探讨男性精神障碍患者发生肇事肇祸行为的相关因素,为预防肇事肇祸行为的发生提供帮助。方法选取2014年3月-2016年1月在北京市安康医院司法鉴定中心进行司法精神病学鉴定的男性精神障碍患者96例纳入研究组,以及首都医科大学附属北京安定医院同期住院的男性精神障碍患者65例纳入对照组。本研究为病例对照研究,采用自编调查问卷,调查患者的一般资料,包括年龄、受教育年限、婚姻状况、民族、文化程度、居住地、职业;疾病史概况,包括首次发病年龄、治疗情况、颅脑疾病史、乙醇饮用史、吸烟史、自杀史、既往住院次数;个人成长史概况,包括是否童年家庭环境不良、是否曾遭父母虐待、是否曾被父母遗弃、父母健康状况、父母婚姻状况、父母有无因精神疾病住院、父母有无犯罪记录、父母有无乙醇或物质滥用、居住方式、家庭是否和睦、家庭月收入;家族史概况,包括有无家族犯罪史、有无家族精神疾病史。采用心理变态测评量表修订版(PCL-R)评价患者的人格特点;采用简明精神病评定量表(BPRS)评价患者的精神症状;采用修改版外显攻击行为量表(MOAS)评价患者的攻击行为。问卷在患者进行鉴定或入院当天由两名经过量表一致性培训的调查员询问患者及家属后填写。结果司法鉴定结果显示发生肇事肇祸行为的精神障碍患者多为精神分裂症(82例,占85.4%);研究组与对照组文化程度、居住地、职业,治疗情况、既往住院次数,家庭月收入比较,差异有统计学意义(P<0.05);与对照组相比,研究组PCL-R的反社会因子得分高,BPRS的思维障碍、敌对性因子得分和总分高,MOAS的财产攻击、体力攻击条目加权分和加权总分高(P<0.05);多因素Logistic回归分析结果显示,文化程度〔OR=8.732,95%CI(1.268,60.123)〕、治疗情况〔OR=45.846,95%CI(4.254,494.149)〕、财产攻击条目加权分〔OR=0.044,95%CI(0.006,0.321)〕、体力攻击条目加权分〔OR=0.035,95%CI(0.005,0.246)〕是男性精神障碍患者发生肇事肇祸行为的影响因素(P<0.05)。结论发生肇事肇祸行为的男性精神障碍患者多为精神分裂症。文化程度低、未积极接受治疗、有财产攻击、体力攻击倾向是男性精神障碍患者发生肇事肇祸行为的危险因素。加强文化教育、积极的治疗手段有助于降低该类患者发生肇事肇祸行为。

氯氮平合用氟西汀治疗男性慢性精神分裂症的对照研究

目的探讨氯氮平合并盐酸氟西汀治疗男性慢性精神分裂症患者阴性症状的疗效。方法对60例以阴性症状为主的慢性精神分裂症男性患者,在原用氯氮平250～450 mg/d剂量不变的基础上,随机分为合用组30例与对照组30例,分别给予盐酸氟西汀(20～40 mg/d)和安慰剂,疗程12周。采用阳性与阴性症状量表(PANSS)和药物副反应量表(TESS)评定疗效和不良反应,于治疗前及治疗第4、8、12周分别评定1次。结果治疗第8周起合用组PANSS总分及阴性因子分均比治疗前及对照组显著降低(P<0.05,P<0.01)。结论氯氮平合并盐酸氟西汀治疗以阴性症状为主的男性慢性精神分裂症患者,可明显改善阴性症状,不良反应少。