精神分裂症患者心肌酶的改变及相关因素分析

发布时间：2018-05-23 07:35

本文选题：肌酸激酶 + 乳酸脱氢酶　；参考：《大连医科大学》2013年硕士论文

【摘要】：目的：分析精神分裂症患者住院期间血清肌酸激酶和乳酸脱氢酶的改变及其相关的影响因素。方法：收集99例精神分裂症患者(研究组)以及101例健康人群(对照组)作为研究对象，研究组分别于入院第2天和第4周末清晨6:00-6:30采肘正中静脉血2ml进行心肌酶分析，对照被试采肘正中静脉血1次，方法同上。采用阳性症状量表(SAPS)和阴性症状量表(SANS)、攻击风险评估表分别于研究组入院第2天和第4周末上午8:00-11:00评估疾病状态和攻击行为。运用Spearman秩相关分析检验治疗前、后CK和LDH与症状的相关性；运用非参数检验对不同等级攻击风险组间CK和LDH差异比较，同时分析性别与攻击风险的关系；采用多重线性逐步回归分析，分析治疗前CK和LDH的影响因素。运用Spearman秩相关分析检验治疗前后CK和LDH变化与症状变化的相关性。结果：1.治疗前CK和LDH值统计分析：阳性症状组、混合症状组和阴性症状组CK和LDH差异不具有统计学意义（P＞0.05）。研究组CK值与对照组CK值差异具有统计学意义（p=0.000）。研究组与对照组LDH值之间差异不具有统计学意义（P＞0.05）。阳性量表总分（r=0.410，p＜0.001）、妄想综合评价（r=0.275，p＜0.05）、阳性思维形式障碍（r=0.288，p＜0.05）与研究组CK值正相关。思维贫乏（r=-0.207，p＜0.05）与CK值负相关。阳性量表总分（r=0.351，p＜0.001）和妄想综合评价（r=0.207，p＜0.05）与研究组LDH正相关。情感平淡迟钝（r=-0.248，p＜0.05）与LDH值负相关。攻击行为影响CK和LDH值。多因素逐步回归分析显示攻击行为（β=0.548，P=0.000）对CK影响最大，其次次为年龄（β=-0.282，P=0.001），正常人群年龄不是CK值的影响因素。多因素逐步回归分析显示攻击行为（β=0.302，P=0.002）是LDH值的影响因素。 2.治疗后CK和LDH值统计分析：研究组CK值与对照组CK值之间差异具有统计学意义（p=0.000）。研究组和对照组LDH值差异不具有统计学意义（P＞0.05）。CK和LDH与阳性和阴性症状不具有相关性（P＞0.05）。 3.治疗前后CK和LDH值比较：研究组自身对照CK值存在显著差异（p=0.000）。治疗前后LDH值差异不具有统计学意义（P＞0.05）。阳性量表总分的变化值（r=0.206，p＜0.05）与CK的变化值正相关。思维贫乏变化值（r=-0.203，p＜0.05）与CK的变化值负相关。妄想症状的变化（r=0.205，p＜0.05）与LDH变化值正相关，，阴性量表差值（r=-0.199，p＜0.05）与LDH的变化值负相关。结论：精神分裂症患者入院初期CK升高是激越攻击行为、精神分裂症症状的综合作用，长期服用抗精神病药物也影响CK水平。其中，躯体活动增加是精神分裂症患者和健康人群CK升高共同的影响因素。CK水平与精神分裂症症状具有相关性，CK可以作为衡量病情状态的指标，具有科研价值。激越攻击行为和精神分裂症症状也是LDH的影响因素，但LDH在整个病程中并无明显变化，LDH对于外界的影响因素不敏感，不能作为衡量疾病状态的指标。
[Abstract]:Aim: to analyze the changes of serum creatine kinase and lactate dehydrogenase in patients with schizophrenia. Methods: 99 schizophrenic patients (study group) and 101 healthy people (control group) were selected as the study subjects. The 2ml of the middle elbow vein blood collected from 6: 00-6: 30 elbow on the second day of admission and the 4th weekend in the study group were analyzed for myocardial enzymes. The blood of the median elbow vein was collected once in the control group. The positive symptom scale (SAPSS) and the negative symptom scale (SANSS) were used to assess the disease status and aggressive behavior at 8: 00-11: 00 at the second day of admission and at the 4th weekend of the study group, respectively. Spearman rank correlation analysis was used to test the correlation between CK and LDH before and after treatment, and nonparametric test was used to compare CK and LDH differences among groups with different levels of attack risk, and the relationship between sex and attack risk was also analyzed. Multiple linear stepwise regression analysis was used to analyze the influencing factors of CK and LDH before treatment. Spearman rank correlation analysis was used to test the correlation between CK and LDH before and after treatment. The result is 1: 1. Statistical analysis of CK and LDH before treatment: there was no significant difference in CK and LDH between positive symptom group, mixed symptom group and negative symptom group (P > 0.05). The difference of CK value between the study group and the control group was statistically significant. There was no significant difference in LDH between the study group and the control group (P > 0.05). The total score of positive scale was 0.410 (p < 0.001), the total score of delusion was 0.275 (P < 0.05), and the total score of positive form of thinking was 0.288 (p < 0.05), which was positively correlated with the value of CK in the study group. Poor thinking r-0.207 (p < 0.05) was negatively correlated with CK. The total score of positive scale was 0.351 (p < 0.001) and the comprehensive evaluation of delusion was 0.207 (p < 0.05), which was positively correlated with LDH in the study group. There was a negative correlation between the LDH value and the affective bland (r)-0.248 (p < 0. 05). Attack behavior affects CK and LDH values. Multivariate stepwise regression analysis showed that aggressive behavior (尾 -0.548P + 0.000) had the greatest effect on CK, followed by age (尾 -0.282). The age of normal population was not the influence factor of CK value. Multivariate stepwise regression analysis showed that aggressive behavior (尾 -0.302) was the influencing factor of LDH. 2. Statistical analysis of CK and LDH value after treatment: the difference between CK value in study group and CK value in control group was statistically significant. The difference of LDH between the study group and the control group was not statistically significant (P > 0.05). There was no correlation between the LDH value and the positive and negative symptoms (P > 0.05). 3. Comparison of CK and LDH values before and after treatment: there were significant differences in CK values between study group and self control group (P < 0. 000). The difference of LDH before and after treatment was not statistically significant (P > 0.05). There was a positive correlation between the change of total score of positive scale and CK (P < 0.05). There was a negative correlation between the value of poor thinking and CK (r = -0.203, p < 0.05). The change of delusion symptom (P < 0.05) was positively correlated with the change value of LDH, and the difference of negative scale (r-0.199p < 0.05) was negatively correlated with the change value of LDH. Conclusion: the elevation of CK in patients with schizophrenia at the early stage of admission is an aggressive behavior. The symptoms of schizophrenia play a comprehensive role. Long-term use of antipsychotics also affects the level of CK. Among them, the increase of physical activity is the common influence factor of CK elevation in schizophrenic patients and healthy people. The level of CK is correlated with the symptoms of schizophrenia. CK can be used as an index to measure the state of the disease and has scientific research value. Agitated aggression and schizophrenia were also the influencing factors of LDH. However, there was no obvious change in LDH during the whole course of disease. LDH was insensitive to the external factors and could not be used as an index to measure the state of the disease.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.3

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