精神分裂症患者骨密度的性别差异

Gender difference of bone mineral density in patients with schizophrenia

  • 摘要:
      目的  检测不同性别精神分裂症患者骨密度(BMD)及生化指标水平,探讨骨代谢异常的性别差异及相关影响因素。
      方法  选取179例精神分裂症患者,其中男89例,女90例。采用定量CT(QCT)测定患者腰椎BMD值,并检测患者血钙、血磷、碱性磷酸酶和甲状旁腺激素水平。
      结果  不同年龄组中男性和女性精神分裂症患者的年龄、受教育年限、体质量指数、病程、药物剂量、阳性与阴性症状量表(PANSS)总分比较,差异均无统计学意义(P>0.05)。男性、女性精神分裂症组患者的BMD值分别低于男性、女性健康对照组人群,差异有统计学意义(P < 0.05)。在51~60岁年龄段,女性精神分裂症患者BMD值低于男性精神分裂症患者,差异有统计学意义(P=0.032)。与男性精神分裂症组患者相比,女性精神分裂症组患者血钙水平较低,而甲状旁腺激素水平较高,差异均有统计学意义(P < 0.05)。男性精神分裂症患者体质量指数、药物剂量与BMD值具有显著相关性(P=0.002、0.043),而女性精神分裂症患者年龄、病程、药物剂量与BMD值具有显著相关性(P=0.005、0.032、0.049)。
      结论  不同性别精神分裂症患者的BMD水平和影响因素存在差异,故改善患者BMD时需要采取不同的干预措施。

     

    Abstract:
      Objective  To detect the levels of bone mineral density (BMD) and biochemical indexes in schizophrenic patients with different gender, and to explore the gender difference and related influencing factors of abnormal bone metabolism.
      Methods  A total of 179 patients with schizophrenia were selected, including 89 males and 90 females. The value of lumbar BMD was measured by quantitative CT (QCT), and the levels of blood calcium, blood phosphorus, alkaline phosphatase and parathyroid hormone were detected as well.
      Results  There were no significant differences in age, years of education, body mass index, course of disease, drug dose and total score of Positive and Negative Symptom Scale (PANSS) between male and female schizophrenic patients in different age groups (P>0.05). The BMD values of male and female schizophrenic patients were significantly lower than those of the matched male and female healthy controls (P < 0.05). In the age group of 51 to 60 years old, the BMD values of female schizophrenic patients were significantly lower than that of male schizophrenic patients (P=0.032). Compared with male schizophrenic patients, female schizophrenic patients had significant lower blood calcium level and higher parathyroid hormone level (P < 0.05). In male schizophrenic patients, the body mass index and drug dose were significantly correlated with BMD (P=0.002, 0.043), while the age, course of disease and drug dose in female schizophrenic patients were significantly correlated with BMD (P=0.005, 0.032, 0.049).
      Conclusion  There are differences in BMD value and influencing factors between schizophrenic patients with different gender, and different intervention measures should be taken to improve BMD.

     

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