精神分裂癥患者治療過程中Hcy水平與血糖、血脂水平的關系

張俊香

[摘要] 目的 探討精神分裂癥患者治療過程中同型半胱氨酸水平與糖脂代謝變化的關系。 方法 選擇2018年1～12月在我院診斷治療的精神分裂癥患者35例為研究對象，根據Hcy水平分為Hcy正常組（19例）與Hcy升高組（16例）。比較兩組入組時與治療4周后FBG、2hPBG 、TG、TC 水平，分析治療后Hcy水平與FBG、2hPBG 、TG、TC的相關性。 結果 入組時，Hcy升高組FBG、2hPBG 、TG、TC 水平高于Hcy正常組，差異有統計學意義（P<0.05）;Hcy升高組治療4周后FBG、2hPBG 、TG、TC 水平高于入組時及對照組，差異有統計學意義（P<0.05）;治療4周后 Hcy正常組FBG、2hPBG 、TG、TC 水平與入組時比較差異無統計學意義（P>0.05）。Hcy水平與FBG呈正相關（r=0.835）。Hcy水平與2hPBG呈正相關（r=0.857）。Hcy水平與TG呈正相關（r=0.883）。Hcy水平與TC相關（r=0.899）。 結論 精神分離癥患者合并Hcy升高在治療過程中對糖脂代謝影響大，在臨床工作中，對精神分裂癥患者治療過程中應積極監測Hcy水平，以指導治療，評估預后。

[關鍵詞] 同型半胱氨酸水平;精神分裂癥;糖脂代謝;空腹血糖;餐后2 h血糖

[中圖分類號] R749.3? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-9701（2020）04-0008-04

Relationship between Hcy level and blood glucose and blood lipid levels in patients with schizophrenia during treatment

ZHANG Junxiang

Department of Psychiatry， Jiamusi Mental Patient Welfare Institute in Heilongjiang Province， Jiamusi? ?154002， China

[Abstract] Objective To investigate the relationship between the level of homocysteine and the changes of glucose and lipid metabolism during the treatment of patients with schizophrenia. Methods A total of 35 patients with schizophrenia diagnosed and treated in our hospital from January to December 2018 were enrolled. According to the Hcy level， they were divided into Hcy normal group （19 cases） and Hcy increased group （16 cases）. The levels of FBG， 2hPBG， TG and TC were compared between the two groups at the time of enrollment and after 4 weeks of treatment. The correlation between Hcy level and FBG， 2hPBG， TG and TC levels was analyzed after treatment. Results At the time of enollment， the levels of FBG， 2hPBG， TG and TC in Hcy-increased group were higher than those in Hcy-positive group（P<0.05）. The levels of FBG， 2hPBG， TG and TC in Hcy-increased group after 4 weeks were higher than those before the time of enrollment and those of the control group， and the difference between two groups was significant（P<0.05）. There was no significant difference in the levels of FBG， 2hPBG， TG and TC in the Hcy group before the time of enrollment and after 4 weeks of treatment（P>0.05）. There was a positive correlation between Hcy level and FBG（r=0.835）. Hcy level was positively correlated with 2hPBG（r=0.857）. Hcy level was positively correlated with TG（r=0.883）. And Hcy level was positively correlated with TC（r=0.899）. Conclusion The increase of Hcy in patients with psychosis has a great influence on the metabolism of glycolipids during the treatment. In clinical work， the level of Hcy should be actively monitored during the treatment of schizophrenia patients to guide treatment and evaluate prognosis.

[Key words] Homocysteine levels; Schizophrenia; Glycolipid metabolism;Fasting blood glucose; 2 h postprandial blood glucose

精神分裂癥是一種復雜而嚴重的精神障礙，起病于青少年晚期及成年早期。全球精神分裂癥的時點患病率為0.28%。目前總體上精神分裂癥的治療效果欠佳，一項綜述顯示，達到臨床及社會康復的患者中位比例僅為13.5%。精神分裂癥患者預期壽命顯著低于一般人。精神分裂癥患者整體預后較差，壽命較一般人短，與合并的軀體疾病有關。近年來研究顯示精神障礙患者可出現血脂異常，而抗精神病藥物可加重血脂異常水平，導致脂代謝紊亂[1-3]。Hcy是含硫氨基酸，為蛋氨酸和半胱氨酸代謝過程中產生的重要中間產物[4，5]。其水平升高，會顯著增加冠心病、外周血管疾病、腦血管疾病的風險[6，7]。本文分析同型半胱氨酸水平與精神分裂癥患者治療過程中糖脂代謝變化的關系?！?br>