男性慢性精神分裂症患者骨密度降低的危险因素研究

发布时间：2018-05-22 17:58

  本文选题：精神分裂症 + 骨密度　； 参考：《苏州大学》2016年硕士论文

【摘要】：目的:研究男性慢性精神分裂症患者骨密度减少的相关危险因素,找寻可能病因,为指导精神分裂症患者骨骼健康提供有效依据。方法:选择2014年6月至2015年6月,在无锡市精神卫生中心长期住院的男性慢性精神分裂症患者157例和居家管理的非住院的男性慢性精神分裂症患者77例为研究对象。采用ALOKA超声波干式骨密度仪器测定患者右足后跟,测得骨密度T值。将本研究的影响因素进行分组:组别(长期住院组和非住院组)、BMI(低BMI、正常BMI、高BMI)、泌乳素(泌乳素升高组和泌乳素正常组)、高血压(非高血压组和高血压组)、糖尿病(非糖尿病组和糖尿病组)、高脂血症(非高脂血症和高脂血症)、联合治疗(单一治疗和联合治疗)等,比较各组的骨密度均值。然后应用Logistic回归分析,得到影响骨密度的主要因素,然后确立Logistic回归方程,并对样本进行预测,与实际诊断结果相比较,以评估模型的诊断价值。结果:1.长期住院组较非住院组的骨密度水平低(P0.05);低BMI组和高BMI组的骨密度水平间存在显著的差异(P0.05);泌乳素升高组骨密度水平较泌乳素正常组骨密度更低(P0.05);高脂血症组较血脂正常组骨密度更低(P0.05),未发现高血压、糖尿病等对骨密度存在显著影响(P0.05),也未发现联合多种抗精神病药物对骨密度造成显著影响(P0.05)。2.Logistic回归分析共筛选出5项对低骨量有统计学意义的指标:病程、BMI、泌乳素升高、高脂血症和长期住院,其回归系数分别为:(B=0.034,P=0.015)、(B=-0.209,P=0.000)、(B=1.283,P=0.000)、(B=0.913,P=0.013)、(B=0.679,P=0.045),其中分类变量泌乳素升高的OR值为3.608(95%CI:1.874-6.947)、高脂血症的OR值为2.491(95%CI:1.216-5.105)、长期住院的OR值为1.972(95%CI:1.014-3.832)。3.Logistic回归方程为LogisticP=3.173+0.034×病程-0.209×BMI+1.283×泌乳素升高+0.913×高脂血症+0.679×长期住院。综合预测模型的灵敏度、特异度和正确预测百分率分别为76.9%,特异度为67.3%,正确预测百分率为74.8%。结论:1.低BMI、泌乳素升高及高脂血症均是男性精神分裂症患者骨密度降低的重要危险因素。2.病程是影响男性慢性精神分裂症患者的另一重要影响因素。3.长期住院也会影响男性精神分裂症骨密度。
[Abstract]:Objective: to study the risk factors of bone mineral density (BMD) loss in male patients with chronic schizophrenia, to find out the possible etiology, and to provide an effective basis for guiding the bone health of schizophrenic patients. Methods: from June 2014 to June 2015, 157 male chronic schizophrenia patients and 77 non-hospitalized male chronic schizophrenia patients in Wuxi Mental Health Center were selected. The right heel was measured by ALOKA ultrasonic dry bone density instrument, and the T value of bone mineral density was measured. The influencing factors of this study were divided into groups: group (long term inpatient and non-hospitalized group) BMIs (low BMIs, normal BMIs, high BMIs), prolactin (prolactin elevated group and normal prolactin group), hypertension (non hypertensive group and hypertension group, glycomuresis group), prolactin (prolactin increased group and prolactin normal group) Diseases (non-diabetic and diabetic), hyperlipidemia (non-hyperlipidemia and hyperlipidemia), combined therapy (single and combined treatment), etc. Bone mineral density (BMD) of each group was compared. Then the main factors affecting BMD were obtained by using Logistic regression analysis, and then the Logistic regression equation was established, and the sample was predicted and compared with the actual diagnostic results to evaluate the diagnostic value of the model. The result is 1: 1. The bone mineral density of long-term inpatient group was lower than that of non-hospitalized group, there was significant difference between low BMI group and high BMI group, the BMD level of prolactin increased group was lower than that of prolactin normal group, and that of hyperlipidemia group was lower than that of prolactin normal group. The bone mineral density of normal blood lipid group was lower than that of normal blood lipid group (P 0.05), and no hypertension was found. Diabetes mellitus had a significant effect on BMD, nor was it found that combined with multiple antipsychotics had a significant effect on BMD. 2. Logistic regression analysis showed that there were five indexes with statistical significance in low bone mass: the course of disease and the increase of prolactin. Hyperlipidemia and long-term hospitalization, 鍏跺洖褰掔郴鏁板垎鍒�涓�:(B=0.034,P=0.015),(B=-0.209,P=0.000),(B=1.283,P=0.000),(B=0.913,P=0.013),(B=0.679,P=0.045),鍏朵腑鍒嗙被鍙橀噺娉屼钩绱犲崌楂樼殑OR鍊间负3.608(95%CI:1.874-6.947),楂樿剛琛，

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