【摘要】

目的 分析精神分裂症患者血清同型半胱氨酸(Hcy)水平与糖脂代谢变化的关系及其影响因素。
方法 选取我院2013年3月至2018年2月收治的256例精神分裂症患者进行研究，检测其血清Hcy和糖脂代谢指标，根据Hcy表达水平分为HHcy组和NHcy组，比较两组患者治疗前后糖脂代谢变化情况，分析血清Hcy水平与糖脂代谢变化相关性及其影响因素。
结果 治疗前两组患者甘油三酯(TG)、高密度脂蛋白胆固醇 (HDL)和空腹血糖(FPG)比较差异均无统计学意义(P>0.05)。治疗后HHcy组TG高于NHcy组，HDL低于NHcy组，差异有统计学意义(P<0.05)。Spearman相关分析显示，血清Hcy水平与TG正相关，与HDL负相关，差异均有统计学意义(r=0.315，-0.306，P<0.05)。不同性别、病程、年龄和治疗方案的患者Hcy表达水平比较差异有统计学意义(P<0.05)。多因素回归分析发现，男性、年龄大、联合用药是导致血清Hcy增高的独立危险因素(P<0.05)。
结论 精神分裂症患者血清Hcy水平受性别、年龄和治疗方案影响，其表达水平可影响脂质代谢变化。

【Abstract】

Objective:To investigate the relationship between serum homocysteine level and changes of glycolipid metabolism in schizophrenic patients and its influencing factors.
Methods:256 patients with schizophrenia admitted to our hospital from March 2013 to February 2018 were selected for the study,serum Hcy and glycolipid metabolic indexes were measured,according to the expression level of Hcy,all were divided into HHcy group and NHcy group,the changes of glycolipid metabolism before and after treatment were compared between the two groups,and the correlation between serum Hcy level and glycolipid metabolic changes and its influencing factors were analyzed.
Results:There was no significant difference in TG,HDL and FPG between the two groups before treatment(P>0.05).After treatment,TG in HHcy group was higher than that in NHcy group and HDL was lower than that in NHcy group(P<0.05).Spearman correlation analysis showed that serum Hcy level was positively correlated with TG and negatively correlated with HDL(r=0.315,-0.306,P<0.05).There were significant differences in Hcy expression among patients with different gender,course of disease,age and treatment regimen(P<0.05).Multivariate regression analysis showed that male,age,combination of drugs were independent risk factors for the increase of serum Hcy(P<0.05).
Conclusion  :The level of serum Hcy in schizophrenia patients is affected by gender, age and treatment plan, and its expression level can affect the changes of lipid metabolism.