住院精神分裂症患者心血管疾病发生风险研究

摘要

Objective To describe the cardiovascular risk profile of inpatients with schizophrenia and estimate the 10-year CVD risk in schizophrenia patients. Methods Four hundred sixty-six randomly selected cases of schizophrenia patients and 507 health controls were included in the study. Body mass index (BMI), Fasting blood glucose (FBG), triglyceride (TG),,total cholesterol (TC), smoking rate (smoking people/total people), Framing-ham Risk Score (FRS), high density lipoprotein-cholesterol (HDL-C) and age of the vessel (VA). The 10-year cardiovascular risk(FRS) and age of the vessel (VA) were assessed using the Framing-ham Risk Score. Results 10-year CVD risk was significantly higher in patients with schizophrenia than in control group [(6.71 ±6.95)％ vs. (4.76 ±3.07)％], (P<0.05). Comparing with the control group, smoking prevalence[(41％) vs. (19％)], MS[(25％) vs. (17％)], BMI[(23.67 ±3.61)kg/m2 vs. (21.73±4.11)kg/m2] and VA[(46.7±15.3) vs. (43.7±9.8)] were higher in patients group. SBP[(119.86±14.90)mmHg vs. (128.10±15.41)mmHg] and HDL-C [(1.08±0.27)mmol/L vs. (1.38±0.22)mmol/L] were lower in patients group than in the healthy controls. The FRS score of the patient group was positively correlated with BMI, FBG level and SBP, waist circumference and smoking index (P<0.05) and was negatively correlated with the levels of HDL-C. Multivariate Linear Regression analysis demonstrated that FRS was correlated with FBG (β=0.181,P<0.01)、SBP (β=0.149,P<0.01)、HDL-C (β=-0.107,P<0.01) and smoking index(β=0.554,P<0.01). Conclusion The risk of cardiovascular disease in patients with schizophrenia over the next 10 years is 6.7％, which is significantly higher compared with the control group. Fasting blood glucose, systolic blood pressure, high density lipoprotein, smoking may be associated with 10-year CVD risk of schizophrenia patients.%目的 探讨住院精神分裂症患者心血管疾病风险特征和预测精神分裂症患者未来10年发生心血管疾病风险.方法 随机收集住院精神分裂症患者466例,测定患者组体质指数(body mass index,BMI)、空腹血糖(fasting plasma glucose,FBG)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、吸烟率(吸烟人数/总人数)、 高密度脂蛋白(high density lipoprotein-cholesterol,HDL-C)、Framing-ham心血管疾病发生风险评分(Framing-ham risk score,FRS)和血管年龄等指标,并与507例健康对照进行比较.其中10年心血管疾病发生风险和血管年龄用Framing-ham心血管疾病风险评分表来计算.结果 住院精神分裂症患者未来10年发生心血管疾病的风险高于对照组[(6.71％±6.95％)vs.(4.76％±3.07％)],差异有统计学意义(P<0.05);与对照组相比,患者组的吸烟率[(41％)vs.(19％)]、代谢综合征患病率[(25％)vs.(17％)]、BMI水平[(23.67±3.61)kg/m2 vs.(21.73±4.11)kg/m2]和血管年龄[(46.7±15.3)岁vs.(43.7±9.8)岁]增加(P<0.05);SBP[(119.86±14.90)mmHg vs.(128.10±15.41)mmHg]和HDL-C水平[(1.08±0.27)mmol/L vs.(1.38±0.22)mmol/L]降低(P<0.05).患者组的FRS总分与BMI、FBG、SBP、腰围及吸烟指数均呈正相关(P<0.05),与HDL-C呈负相关(P<0.05).多因素线性回归分析示,FRS总分与FBG(β=0.181,P<0.01)、SBP(β=0.149,P<0.01)、HDL-C(β=-0.107,P<0.01)和吸烟指数(吸烟支数×吸烟年数)(β=0.554,P<0.01)有关联.结论 研究发现住院精神分裂症患者未来10年发生心血管疾病的风险为6.7％,显著高于对照组.空腹血糖、收缩压、高密度脂蛋白、吸烟可能与精神分裂症患者未来10年发生心血管疾病有关联.