某公立精神病院长期住院精神分裂症患者的非酒精性脂肪肝

T. Lee, Bo-Jian Wu, Chuang Yu, Tso-Jen Wang
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引用次数: 2

摘要

目的:非酒精性脂肪性肝病(NAFLD)是由代谢综合征引起的一种值得注意的慢性肝病,在长期住院的精神分裂症患者中尚待探讨。在这项研究中,我们打算研究长期住院的精神分裂症患者NAFLD的患病率及其相关危险因素。方法:从台湾某公立精神病院招募182例精神分裂症患者。所有患者均行腹部超声检查。除年龄和性别外,logistic回归模型还包括医学诊断(如高血压、高甘油三酯血症、高胆固醇血症和糖尿病)、肥胖、研究前抗精神病药物一年累积剂量、肝功能异常等协变量。结果:平均年龄±标准差(SD)为50.3±9.2岁。平均住院时间±SD为8.7±5.0年。男性占60.4%(110/182)。NAFLD比例为70.8%(129/182)。在多因素logistic回归中,诊断为高甘油三酯血症的患者的奇比(OR)(95%可信区间[CI])为4.3 (1.11-16.7,p < 0.05),发现肥胖的患者的奇比(OR)为15.8 (3.82-65.6,p < 0.01),显著高于NAFLD。慢性乙型肝炎患者发生NAFLD的差异无统计学意义(OR [95% CI] = 0.17[0.05-0.6])。结论:本研究中长期住院的精神分裂症患者NAFLD患病率较高。我们建议,精神分裂症患者和长期住院的患者需要及时、全面、迅速地评估NAFLD的存在,并且对他们的NAFLD进行干预是维持他们的健康和生活质量的强制性措施。
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Nonalcoholic fatty liver disease among long-term hospitalized patients with schizophrenia in a public psychiatric hospital
Objectives: Nonalcoholic fatty liver disease (NAFLD) is a notable chronic liver disease due to metabolic syndrome, which has yet to be explored in long-term hospitalized patients with schizophrenia. In this study, we intended to study the prevalence of NAFLD and related risk factors for patients with schizophrenia who were long-term hospitalized. Methods: All of 182 patients with schizophrenia were recruited from a public psychiatric hospital in Taiwan. Abdomen ultrasonography was carried out for all patients. In addition to age and sex, covariates including medical diagnoses (e.g., hypertension, hypertriglyceridemia, hypercholesterolemia, and diabetes), obesity, one-year cumulative dose of antipsychotics before the entry of this study, and abnormal liver function were included in the logistic regression model. Results: The mean age ± standard deviation (SD) was 50.3 ± 9.2 years. The mean duration ± SD of hospitalization was 8.7 ± 5.0 years. Males accounted for 60.4% (110/182). The percentage of NAFLD was 70.8% (129/182). In multivariate logistic regression, patients' odd ratios (OR) (95% confidence interval [CI]) for a diagnosis of hypertriglyceridemia were 4.3 (1.11–16.7, p < 0.05) and for a finding of obesity 15.8 (3.82–65.6, p < 0.01), were significantly to have NAFLD. But patients with chronic hepatitis B were not significant to have NAFLD (OR [95% CI] = 0.17 [0.05–0.6]). Conclusion: The prevalence of NAFLD was high in patients with long-term hospitalized patients with schizophrenia in this study. We suggest that patients with schizophrenia and with long-term hospitalization need to receive timely, comprehensive, and prompt assessments for the presence of NAFLD as well as that intervention for their NAFLD is mandatory for maintaining well-being and quality of life in them.
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