CAJ | 학술논문

目的探讨影响精神分裂症首次发病(以下简称首发)患者疗效和复发的相关因素.方法采用前瞻性队列研究,结合全病程管理模式,对453例符合国际疾病分类第10版精神分裂症和分裂样精神障碍诊断标准、基线阳性和阴性症状量表(PANSS)总分≥60分、病程≤5年的患者,进行1年随访,对13项相关因素与近期疗效及复发情况进行单因素分析,并采用Spearman相关分析和t检验.结果 PANSS总分减分率与性别(r=0.083)、病程(r=-0.228)、起病形式(r=-0.180)、发病诱因(r=0.080)、持续用药时间(r=0.153)存在相关关系(P<0.05～0.01);疾病复发与性别(r=-0.131)、持续用药时间(r=0.131)亦存在相关关系(P<0.01).结论女性、病程短、起病形式急、病前有诱因、持续用药时间长的精神分裂症首发患者1年的疗效相对好;男性患者及持续用药时间短的患者易复发.
목적 탐토영향정신분렬증수차발병(이하간칭수발)환자료효화복발적상관인소.방법 채용전첨성대렬연구,결합전병정관리모식,대453례부합국제질병분류제10판정신분렬증화분렬양정신장애진단표준、기선양성화음성증상량표(PANSS)총분≥60분、병정≤5년적환자,진행1년수방,대13항상관인소여근기료효급복발정황진행단인소분석,병채용Spearman상관분석화t검험.결과 PANSS총분감분솔여성별(r=0.083)、병정(r=-0.228)、기병형식(r=-0.180)、발병유인(r=0.080)、지속용약시간(r=0.153)존재상관관계(P<0.05～0.01);질병복발여성별(r=-0.131)、지속용약시간(r=0.131)역존재상관관계(P<0.01).결론 녀성、병정단、기병형식급、병전유유인、지속용약시간장적정신분렬증수발환자1년적료효상대호;남성환자급지속용약시간단적환자역복발.
Objective The study aimed to explore the main factors related to the effectiveness and relapse for first-episode schizophrenia. Methods It was a one year follow-up prospective cohort study with integrated case management. Four hundred and Fifty-three patients, with less than 5-year course of disease, were included who met ICD-10 criteria for schizophrenia (88%) or schizophreniform disorder (12%) and the baseline PANSS scores ≥ 60. Relations between 13 index in the self-made log scale and the reduction rate of total score of PANSS or relapse were analyzed. Spearman's bivariate correlation analysis and t test were adopted. Results Pattern of episode, with or without inducement, gender and time form illness were factors significantly related to reduction rate of PANSS score (r=-0.180, P<0.01; r=0.080, P=0.045;r=0.083, P=0.032; r=-0.228, P<0.01, respectively).Gender and the time to discontinuation were the factors significantly related to relapse or not (r=-0.131, P=0.005, r=0.131, P=0.003, respectively). Conclusions For first-episode schizophrenia, patients with acute pattern of episode, with inducement, with short time form illness, of female and of long time to discontinuation have relatively higher reduction rate of PANSS score, and patients of males and with short time to discontinuation are relatively liable to relapse.