2022年上海市社区精神分裂症患者心血管疾病共病现状及影响因素

Comorbidity status of cardiovascular diseases and its influencing factors in community-based schizophrenia patients in Shanghai, 2022

  • 摘要:
    目的 了解上海市社区精神分裂症患者心血管疾病的患病情况及影响因素,为早期识别和预防该人群的心血管疾病提供科学依据。
    方法 基于2022年上海市严重精神障碍社区队列基线调查数据,采用分层整群抽样法纳入3 954例社区精神分裂症患者,通过问卷调查、体格检查和实验室检查收集研究对象的基本信息和相关临床资料(代谢指标数据)。采用χ2检验进行单因素分析,采用多因素logistic回归分析心血管疾病共病的影响因素。
    结果 研究共纳入3 954例社区精神分裂症患者,心血管疾病共病者1 237例,占总人数的31.28%。多因素logistic回归分析结果显示,年龄≥60岁(OR=5.524,95%CI:3.716~8.214)、有吸烟行为(OR=1.328,95%CI:1.042~1.692)、超重(OR=1.900,95%CI:1.046~3.451)或肥胖(OR=2.678,95%CI:1.439~4.985)、血压升高(OR=1.546,95%CI:1.294~1.846)、空腹血糖异常(OR=1.552,95%CI:1.322~1.823)和高密度脂蛋白胆固醇异常(OR=1.283,95%CI:1.025~1.606)均与精神分裂症患者共病心血管疾病的风险正相关,文化程度为大专/本科及以上(OR=0.640,95%CI:0.450~0.910)和未婚(OR=0.552,95%CI:0.457~0.667)与心血管疾病的共病风险负相关。
    结论 老年、不良行为生活方式以及血压、血糖和血脂异常均可增加社区精神分裂症患者心血管疾病共病的风险,建议未来应加强该人群上述风险因素的监测与管理,实现心血管疾病的早发现、早诊断和早干预。

     

    Abstract:
    Objective To investigate the prevalence of cardiovascular diseases and their influencing factors in community-based schizophrenia patients in Shanghai, and to provide a scientific basis for the early identification and prevention of cardiovascular disease in this population.
    Methods Based on the Shanghai community cohort with severe mental disorders in 2022, a total of 3 954 community-based schizophrenia patients were identified and included in this study through a stratified cluster sampling method. Basic information and relevant clinical data (including metabolic index data) were collected through questionnaire survey, physical examination and laboratory testing. Univariate analyses were performed using the chi-square tests, and multivariate logistic regression analyses were employed to identify influencing factors of comorbid cardiovascular diseases.
    Results A total of 3 954 community-based schizophrenia patients were included, of which a total of 1 237 (31.28%) patients had comorbid cardiovascular diseases. Multivariate logistic regression analyses showed that age 60 years old or above (OR=5.524, 95%CI: 3.716‒8.214), smoking behavior (OR=1.328, 95%CI: 1.042‒1.692), overweight (OR=1.900, 95%CI: 1.046‒3.451) or obesity (OR=2.678, 95%CI: 1.439‒4.985), elevated blood pressure (OR=1.546, 95%CI: 1.294‒1.846), abnormal fasting blood glucose (OR=1.552, 95%CI: 1.322‒1.823) and high-density lipoprotein cholesterol abnormalities (OR=1.283, 95%CI: 1.025‒1.606) were positively associated with the risk of comorbid cardiovascular diseases in patients with schizophrenia, while educational attainment of college/bachelor’s degree or above (OR=0.640, 95%CI: 0.450‒0.910) and being unmarried (OR=0.552, 95%CI: 0.457‒0.667) were negatively associated with the risk of cardiovascular diseases comorbidity.
    Conclusion Advanced age, unhealthy behaviors and lifestyles, as well as abnormalities in blood pressure, blood glucose, and blood lipids, could all increase the risk of comorbid cardiovascular diseases in community schizophrenia patients. It is suggested to strengthen the monitoring and management of these risk factors in this population in the future, so as to achieve early detection, early diagnosis and early intervention of cardiovascular diseases.

     

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