本文選題：精神分裂癥 + 骨密度��； 參考：《蘇州大學(xué)》2016年碩士論文

【摘要】：目的:研究男性慢性精神分裂癥患者骨密度減少的相關(guān)危險(xiǎn)因素,找尋可能病因,為指導(dǎo)精神分裂癥患者骨骼健康提供有效依據(jù)。方法:選擇2014年6月至2015年6月,在無錫市精神衛(wèi)生中心長期住院的男性慢性精神分裂癥患者157例和居家管理的非住院的男性慢性精神分裂癥患者77例為研究對(duì)象。采用ALOKA超聲波干式骨密度儀器測(cè)定患者右足后跟,測(cè)得骨密度T值。將本研究的影響因素進(jìn)行分組:組別(長期住院組和非住院組)、BMI(低BMI、正常BMI、高BMI)、泌乳素(泌乳素升高組和泌乳素正常組)、高血壓(非高血壓組和高血壓組)、糖尿病(非糖尿病組和糖尿病組)、高脂血癥(非高脂血癥和高脂血癥)、聯(lián)合治療(單一治療和聯(lián)合治療)等,比較各組的骨密度均值。然后應(yīng)用Logistic回歸分析,得到影響骨密度的主要因素,然后確立Logistic回歸方程,并對(duì)樣本進(jìn)行預(yù)測(cè),與實(shí)際診斷結(jié)果相比較,以評(píng)估模型的診斷價(jià)值。結(jié)果:1.長期住院組較非住院組的骨密度水平低(P0.05);低BMI組和高BMI組的骨密度水平間存在顯著的差異(P0.05);泌乳素升高組骨密度水平較泌乳素正常組骨密度更低(P0.05);高脂血癥組較血脂正常組骨密度更低(P0.05),未發(fā)現(xiàn)高血壓、糖尿病等對(duì)骨密度存在顯著影響(P0.05),也未發(fā)現(xiàn)聯(lián)合多種抗精神病藥物對(duì)骨密度造成顯著影響(P0.05)。2.Logistic回歸分析共篩選出5項(xiàng)對(duì)低骨量有統(tǒng)計(jì)學(xué)意義的指標(biāo):病程、BMI、泌乳素升高、高脂血癥和長期住院,其回歸系數(shù)分別為:(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),其中分類變量泌乳素升高的OR值為3.608(95%CI:1.874-6.947)、高脂血癥的OR值為2.491(95%CI:1.216-5.105)、長期住院的OR值為1.972(95%CI:1.014-3.832)。3.Logistic回歸方程為LogisticP=3.173+0.034×病程-0.209×BMI+1.283×泌乳素升高+0.913×高脂血癥+0.679×長期住院。綜合預(yù)測(cè)模型的靈敏度、特異度和正確預(yù)測(cè)百分率分別為76.9%,特異度為67.3%,正確預(yù)測(cè)百分率為74.8%。結(jié)論:1.低BMI、泌乳素升高及高脂血癥均是男性精神分裂癥患者骨密度降低的重要危險(xiǎn)因素。2.病程是影響男性慢性精神分裂癥患者的另一重要影響因素。3.長期住院也會(huì)影響男性精神分裂癥骨密度。
[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負(fù):(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鉤绱犲崌楂樼殑OR鍊間負(fù)3.608(95%CI:1.874-6.947),楂樿剛琛，

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