中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2008年
3期
1-3
,共3页
朱海兵%李洁%邱畅%黄杏梅%党亚梅%刘学军%王丹逢%林育华
硃海兵%李潔%邱暢%黃杏梅%黨亞梅%劉學軍%王丹逢%林育華
주해병%리길%구창%황행매%당아매%류학군%왕단봉%림육화
精神分裂症%胰岛素抵抗%代谢综合征
精神分裂癥%胰島素牴抗%代謝綜閤徵
정신분렬증%이도소저항%대사종합정
Schizophrenia%Insulin resistance%Metabolic syndrome
目的 分析首发未用药的精神分裂症患者伴发代谢紊乱的临床状况,并探讨其病理生理机制.方法 选择首发未用药的非高血压、非糖尿病的精神分裂症患者120例,检测患者的腰围、体质量指数(BMI)、空腹血糖血脂、胰岛素浓度等,采用稳态模型评估指数和国际糖尿病联盟(IDF)代谢综合征全球标准评估胰岛素抵抗(IR)和代谢综合征的发生,同时,采用阳性和阴性症状量表(PANSS)评定精神分裂症的严重程度.结果 120例首发精神分裂症患者中,中心性肥胖者占28.3%.胰岛素分泌不足占20%,IR占35%,10.83%达到IDF代谢综合征标准,年长的女性患者发生代谢紊乱更明显.腰围与BMI呈正相关(r=0.758,P＜0.01),均与年龄、体质量、FBG、TC、TG浓度呈正相关,与病程、FINS浓度无相关性;IR指数与腰围(r=0.207,P＜0.05)和FINS浓度呈正相关,与其他指标无相关性;各代谢指标,IR指数等与PANSS总分和各亚分差异无统计学意义(P＞0.05).结论 首发未用药的精神分裂症伴胰岛素抵抗和代谢综合征的发生率高,值得重视,有必要建立针对中心性肥胖、胰岛素抵抗和脂质代谢紊乱的早期干预模式.
目的 分析首髮未用藥的精神分裂癥患者伴髮代謝紊亂的臨床狀況,併探討其病理生理機製.方法 選擇首髮未用藥的非高血壓、非糖尿病的精神分裂癥患者120例,檢測患者的腰圍、體質量指數(BMI)、空腹血糖血脂、胰島素濃度等,採用穩態模型評估指數和國際糖尿病聯盟(IDF)代謝綜閤徵全毬標準評估胰島素牴抗(IR)和代謝綜閤徵的髮生,同時,採用暘性和陰性癥狀量錶(PANSS)評定精神分裂癥的嚴重程度.結果 120例首髮精神分裂癥患者中,中心性肥胖者佔28.3%.胰島素分泌不足佔20%,IR佔35%,10.83%達到IDF代謝綜閤徵標準,年長的女性患者髮生代謝紊亂更明顯.腰圍與BMI呈正相關(r=0.758,P＜0.01),均與年齡、體質量、FBG、TC、TG濃度呈正相關,與病程、FINS濃度無相關性;IR指數與腰圍(r=0.207,P＜0.05)和FINS濃度呈正相關,與其他指標無相關性;各代謝指標,IR指數等與PANSS總分和各亞分差異無統計學意義(P＞0.05).結論 首髮未用藥的精神分裂癥伴胰島素牴抗和代謝綜閤徵的髮生率高,值得重視,有必要建立針對中心性肥胖、胰島素牴抗和脂質代謝紊亂的早期榦預模式.
목적 분석수발미용약적정신분렬증환자반발대사문란적림상상황,병탐토기병리생리궤제.방법 선택수발미용약적비고혈압、비당뇨병적정신분렬증환자120례,검측환자적요위、체질량지수(BMI)、공복혈당혈지、이도소농도등,채용은태모형평고지수화국제당뇨병련맹(IDF)대사종합정전구표준평고이도소저항(IR)화대사종합정적발생,동시,채용양성화음성증상량표(PANSS)평정정신분렬증적엄중정도.결과 120례수발정신분렬증환자중,중심성비반자점28.3%.이도소분비불족점20%,IR점35%,10.83%체도IDF대사종합정표준,년장적녀성환자발생대사문란경명현.요위여BMI정정상관(r=0.758,P＜0.01),균여년령、체질량、FBG、TC、TG농도정정상관,여병정、FINS농도무상관성;IR지수여요위(r=0.207,P＜0.05)화FINS농도정정상관,여기타지표무상관성;각대사지표,IR지수등여PANSS총분화각아분차이무통계학의의(P＞0.05).결론 수발미용약적정신분렬증반이도소저항화대사종합정적발생솔고,치득중시,유필요건립침대중심성비반、이도소저항화지질대사문란적조기간예모식.
Objective The aim of this sdudy was to analyse the metabolic abnormalities in first epirode, drug-free schizophrenia, and discuss the pathophysiologic mechanisms. Methods 120 patients with the first-epizode and drug-free schizophrenics, who met CCMD-3 and excluded hypertension and diabetes, were measured the BMI, waistline, the fasting blood glucoses (FBG) and insulin concentration (FIC), the cholesterol and TG before treatment. Subjects were assessed for the presence of insulin resistance using homeostasis model assessment(HOMA) and metabolic syndrome according to the criteria by the International Diabetes Federation (IDF),and we rated the positive and negative symptoms scales (PANSS). Results Metabolic abnormalities were already present in first-epizode patients ,28. 3% with centricity fatness, 20% with the lower FIC, 35% with insulin resistance, and 10. 83% achieving the criteria of metabolic syndrome, and much higher rates of metabolic abnormalities were observed in the older and female subjects. In patients, there were significantly correlations between waistline and body mass index (BMI) (n=120, r=0.758,P＜0.01). They were also positively related to the age, weight, the FBG ,TG and cholesterol concentration, but had no relationship to the durations and FIC. The index of insulin resistance was positively related to waistline (r=0.207, P＜0.05) and the fasting insulin concentration. The metabolic indexes were negatively related to the P, N, G and the totoal scores of PANSS(P＞ 0.05). Conclusion The current data suggested that the high incidence of the insulin resistance and metabolic syndrome be a major problem for the first-epside schizophrenia patients. We should build the early interference models for metabolic abnormalities including the centricity fatness, the insulin resistance and lipid abnormalities in first-epside schizophrenia patients.
