摘要
目的:了解稳定期精神分裂症住院患者镇静催眠药使用情况及探讨稳定期精神分裂症住院患者睡眠现况并分析其影响因素。方法:本次研究纳入2019年8月-2022年4月在北京市通州区精神病医院住院的精神分裂症稳定期患者77例,通过自制临床调查表对患者进行临床资料调查,包括住院期间镇静催眠药物使用情况,采用匹茨堡睡眠质量指数(PSQI)评价患者的睡眠状况,简明精神病量表(BPRS)对患者的精神症状进行评估,简易智能状态检查量表(MMSE)对患者进行认知功能评估,并进行临床总体印象严重程度量表(CGI)的评估,使用单因素及多因素logistic回归对睡眠障碍患者的相关因素进行分析。Pearson相关分析PSQI与BPRS、MMSE、服用药物时间、CGI等的相关性。结果:纳入精神分裂症稳定期77例,其中有11例患者使用镇静催眠药,即镇静催眠药使用率14.3%;使用苯二氮类10例,使用率为13.0%。77例中22例存在睡眠障碍,睡眠障碍发生率为28.6%。对入组的77例患者按照是否存在睡眠障碍进行分组,分为睡眠障碍组(22例)与无睡眠障碍组(55例)。单因素分析结果显示,睡眠障碍组服用镇静催眠药患者比例高于无睡眠障碍组,而其BPRS得分显著高于无睡眠障碍组,差异均有统计学意义(P<0.05)。两组性别、年龄、教育程度、婚姻状况、饮酒、抗抑郁药的应用、MMSE及CGI水平比较差异均无统计学意义(P>0.05)。无睡眠障碍组患者规律服药的时间明显长于有睡眠障碍组患者,但差异无统计学意义(P>0.05)。多因素logistic回归分析,结果显示,在控制了其他因素后,BPRS是睡眠障碍的独立影响因素(P<0.05)。Pearson相关性分析显示,患者PSQI分数与MMSE、服用药物时间、CGI无相关性(P>0.05)。PSQI量表得分与BPRS得分呈正相关(r=0.302,P<0.05)。结论:北京市通州区精神病医院稳定期精神分裂症患者镇静催眠类药物使用整体上较为合理,不存在滥用。本研究发现无睡眠障碍组患者未服用镇静催眠药的比例明显高于有睡眠障碍组患者。且急性期后残留症状是睡眠障碍的独立影响因素。对于急性期住院患者规范化治疗,尽量减少患者稳定期残留症状,稳定期患者残留症状越少,睡眠质量越好。
Objective:To investigate the use of sedative hypnotics in hospitalized patients with stable schizophrenia,and to explore the sleep status and its influencing factors.Method:A total of 77 patients with stable schizophrenia who were hospitalized in Tongzhou District Psychiatric Hospital of Beijing from August 2019 to April 2022 were included in this study.The clinical data were investigated by self-made clinical questionnaire,including the use of sedative hypnotics during hospitalization.The sleep status of the patients was evaluated by Pittsburgh sleep quality index(PSQI).The brief psychiatric scale(BPRS)was used to evaluate the mental symptoms of patients,the mini-mental state examination(MMSE)was used to evaluate the cognitive function of patients,and the clinical global impression of severity(CGI)scale was used to evaluate the severity of sleep disorders.Univariate and multivariate logistic regression analysis were used to analyze the related factors of patients with sleep disorders.Pearson correlation analysis was performed to analyze the correlation between PSQI and BPRS,MMSE,drug taking time,CGI,etc.Result:Seventy-seven patients with stable schizophrenia were included,among which 11 patients used sedative hypnotics,namely,the utilization rate of sedative and hypnotic drugs was 14.3%.Benzodiazepines were used in 10 cases,and the rate of Benzodiazepine use was 13.0%.Among 77 patients,22 patients had sleep disorders,and the incidence of sleep disorders was 28.6%.A total of 77 patients were divided into sleep disorder group(n=22)and no sleep disorder group(n=55)according to whether there were sleep disorders.The results of univariate analysis showed that the rate of patients taking sedative hypnotics in the sleep disorder group of stable schizophrenia patients was significantly higher than that in the non-sleep disorder group,while the BPRS scores was significantly higher than that in the non-sleep disorder group,and the difference was statistically significant(P<0.05).There were no significant differences in gender,age,education level,marital status,drinking,use of antidepressants,MMSE and CGI levels between the two groups(P>0.05).The time of regular medication in patients non-sleep disorder group was significantly longer than that in patients with sleep disorder group,but the difference was not statistically significant(P>0.05).Multivariate logistic regression analysis showed that BPRS was an independent influencing factor of sleep disorders after controlling for other factors(P<0.05).Pearson correlation analysis showed that there was no significant correlation between PSQI scores and MMSE,medication time and CGI(P>0.05).PSQI scores was positively correlated with BPRS scores(r=0.302,P<0.05).Conclusion:Sedative hypnotics in schizophrenic patients at stable stage in Tongzhou District Psychiatric Hospital of Beijing is reasonable and there is no abuse.This study finds that the rate of patients without sleep disorders who did not take sedative hypnotics is significantly higher than that of patients with sleep disorders.Residual symptoms after acute phase is independent influencing factors of sleep disturbance.For the standardized treatment of hospitalized patients in the acute phase,the residual symptoms of patients in the stable phase should be reduced as far as possible.The less residual symptoms of patients in the stable phase,the better their sleep quality.
作者
张秋伏
靳晓磊
张本娜
周琦
刘宇佳
雷武军
周红
ZHANG Qiufu;JIN Xiaolei;ZHANG Benna;ZHOU Qi;LIU Yujia;LEI Wujun;ZHOU Hong(Tongzhou District Psychiatric Hospital of Beijing,Beijing 101118,China;不详)
出处
《中国医学创新》
CAS
2023年第4期71-75,共5页
Medical Innovation of China
关键词
稳定期
精神分裂症
睡眠障碍
镇静催眠药
影响因素
Stationary phase
Schizophrenia
Sleep disorders
Sedative hypnotics
Factors affecting
