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首发精神分裂症后急性心肌梗死风险增加:6 年随访研究。

Increased risk of acute myocardial infarction after acute episode of schizophrenia: 6 year follow-up study.

机构信息

Department of Psychiatry, PoJen General Hospital, Taipei, Taiwan.

出版信息

Aust N Z J Psychiatry. 2010 Mar;44(3):273-9. doi: 10.3109/00048670903487209.

DOI:10.3109/00048670903487209
PMID:20050720
Abstract

OBJECTIVE

The aim of the present study was to estimate the risk of acute myocardial infarction (AMI) among patients who received a first hospital diagnosis of schizophrenia during a 6 year follow-up period.

METHOD

Data from the Taiwan National Health Insurance Research Database were used. The study cohort consisted of 7353 patients who were hospitalized with a principal diagnosis of schizophrenia in 2000. The comparison cohort were 22 059 enrollees randomly selected matched with the study group in terms of gender and age. Each patient was tracked from their index hospitalization in 2000 until the end of 2006 to identify whether or not an AMI had occurred during the follow-up period. Cox proportional hazard regressions were performed to compute the adjusted 6 year survival rate, following adjustment for possible confounding variables.

RESULTS

A total of 130 patients suffered AMI during the 6 year follow-up period, including 30 from the study cohort (0.41% of the schizophrenia patients), and 100 (0.45%) from the comparison cohort. But after censoring those patients who died from non-AMI causes and adjusting for potential confounding factors, the risk of AMI occurrence during the 6 year follow-up period was 1.83-fold greater for schizophrenia patients (95% confidence interval 5 1.62-2.05) than for patients in the comparison cohort.

CONCLUSION

Schizophrenia patients had a higher risk of AMI compared to patients in the comparison cohort. The present study draws attention to the need for clinicians to more actively monitor and treat schizophrenia patients with well-recognized risk factors associated with AMI.

摘要

目的

本研究旨在评估在 6 年随访期间首次被诊断为精神分裂症的患者发生急性心肌梗死(AMI)的风险。

方法

本研究使用了来自台湾全民健康保险研究数据库的数据。研究队列包括 2000 年因主要诊断为精神分裂症住院的 7353 名患者。对照组为 22059 名与研究组在性别和年龄方面相匹配的参保者。每位患者从 2000 年的住院指数开始追踪,直到 2006 年底,以确定在随访期间是否发生 AMI。采用 Cox 比例风险回归计算调整后的 6 年生存率,调整了可能的混杂变量。

结果

在 6 年的随访期间,共有 130 名患者发生 AMI,其中研究队列中有 30 名(精神分裂症患者的 0.41%),对照组中有 100 名(0.45%)。但是,在排除那些因非 AMI 原因死亡的患者并调整潜在混杂因素后,精神分裂症患者在 6 年随访期间发生 AMI 的风险是对照组的 1.83 倍(95%置信区间 5.16-2.05)。

结论

与对照组相比,精神分裂症患者发生 AMI 的风险更高。本研究提请临床医生注意,需要更积极地监测和治疗有公认的 AMI 相关风险因素的精神分裂症患者。

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