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投稿时间：2020-08-01 网络发布日期：2020-11-20
投稿时间：2020-08-01 网络发布日期：2020-11-20
中文摘要: 目的 探讨长期服用抗精神病药的精神分裂症患者便秘情况及其影响因素,以利于便秘的临床防治。方法 选择2019年12月至2020年6月长期服用抗精神病药的临床稳定期精神分裂症患者159例,根据罗马Ⅳ功能性便秘诊断标准将患者分为便秘组（56例）和非便秘组（103例）。采用阳性和阴性症状量表(PANSS)评估精神症状,便秘评估量表(CAS)和布里斯托粪便分型量表(BSS)评定便秘严重程度;比较便秘组与非便秘组社会人口学及临床资料,运用多因素Logistic回归分析便秘的影响因素。结果 159例患者中发生便秘56例(35.22%),其中45例患者服用氯氮平，服用氯氮平者便秘发生率为55.56%（25/45）；服用非氯氮平者便秘发生率为27.19%（31/114）；服用氯氮平者便秘发生率高于服用非氯氮平者（χ2=11.376，P=0.001）。秘组CAS量表评分高于非便秘组,BSS量表评分低于非便秘组,差异有统计学意义(P<0.01);便秘组病程、住院次数高于非便秘组,体重和BMI低于非便秘组,差异有统计学意义(P<0.05，P<0.01)。Pearson相关性分析显示,BSS评分与体重、BMI呈正相关关系,与病程、年龄呈负相关关系（P<0.05）。回归分析结果显示，服用氯氮平、BMI低、一般精神病理量表分低是服用抗精神病药物所致便秘的重要危险因素（P<0.05，P<0.01）。结论 抗精神病药物所致便秘发生率高,临床中对服用氯氮平和低BMI患者需要重视其便秘症状。
中文关键词: 精神分裂症 抗精神病药 便秘 氯氮平；一般精神病理量表
Abstract:Objective To investigate the incidence and risk factors of constipation in patients with schizophrenia who have taken antipsychotics for a long time,so as to facilitate the clinical prevention and treatment of constipation.Methods A total of 159 patients with clinically stable schizophrenia who took antipsychotics for a long time from December 2019 to June 2020 were enrolled.Patients were divided into constipation group and non-constipation group according to the Rome Ⅳ diagnostic criteria for functional constipation.The Positive and Negative Symptom Scale (PANSS) was used to assess psychiatric symptoms.The Constipation Assessment Scale(CAS) and Bristol Stool Scale(BSS) were used to assess the severity of constipation.Sociodemographic and clinical data were compared between constipation group and non-constipation group.The Logistic regression analysis was performed to identify risk factors for constipation in schizophrenia patients.Results The overall rate for constipation in patients with schizophrenia was 35.22%(56/159),Among them,45 patients took clozapine and their incidence of constipation was 55.56%(25/45);the incidence of constipation in patients taking non-clozapine［27.19%（31/114）］ was the lower incidence of constipation was in those taking clozapine( χ2=11.376 ， P=0.001).The CAS score of the constipation group was higher than that of the non-constipation group,and the BSS score was lower than that of the non-constipation group( P<0.01).The duration of disease and the number of hospitalizations in the constipation group were higher than those in the non-constipation group( P<0.05),and the weight and BMI were lower than those in the non-constipation group( P<0.05, P<0.01).Pearson correlation analysis showed that BSS score was significantly positively correlated with body weight and BMI,and negatively correlated with disease course and age(P<0.05).Logistic regression analysis showed that taking clozapine,low BMI,and general psychopathology scored low are important risk factors for constipation caused by taking antipsychotics( P<0.05, P<0.01).ConclusionSchizophrenia patients with long-term antipsychotics had high incidence for constipation,and those treated with clozapine and with low BMI may warrant more attention in clinical practice.
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基金项目:科技部重点研发计划重大慢病项目(2018YFC1314300);国家自然科学基金面上项目(81971255);江苏省科技厅社会发展面上项目(BE2019610);江苏省医学重点人才项目(ZDRCA2016075);南京市江宁区社会事业科技发展计划(2020SHSY0105)
引用文本：
邵苗苗,徐越,方新宇,等.长期抗精神病药物所致便秘发生率及影响因素分析[J].中国临床研究,2020,33(11):1502-1506.
邵苗苗,徐越,方新宇,等.长期抗精神病药物所致便秘发生率及影响因素分析[J].中国临床研究,2020,33(11):1502-1506.