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检测精神分裂症患者的亚临床动脉粥样硬化和舒张功能障碍。

Detection of subclinical atherosclerosis and diastolic dysfunction in patients with schizophrenia.

机构信息

Department of Psychiatry, Namık Kemal University, School of Medicine, Tekirdag, Turkey.

出版信息

Neuropsychiatr Dis Treat. 2013;9:1531-7. doi: 10.2147/NDT.S52030. Epub 2013 Oct 8.

Abstract

BACKGROUND

Patients with schizophrenia have a higher risk for cardiovascular diseases, which is associated with early mortality compared with the nonschizophrenic population. Early diagnosis of cardiovascular diseases in asymptomatic periods in patients with schizophrenia would enhance their quality of life and reduce mortality. Echocardiography, carotid ultrasonography, and ankle brachial index (ABI) measurement are known to be beneficial methods of detecting subclinical cardiovascular diseases and of risk stratification. The present study investigated carotid intima media thickness (CIMT) and ABI and echocardiographic parameters measured via conventional and tissue Doppler echocardiography in patients with schizophrenia in comparison with a control group.

METHODS

The present case-control study included 116 patients with schizophrenia and 88 healthy patients. Participants with any current comorbid psychiatric disorder, current or lifetime neurological and medical problems, current coronary artery disease, diabetes, hypertension, hypothyroidism, or hyperthyroidism or who were using antihypertensives, antidiabetic agents, or antiobesity drugs were excluded. High-resolution B-mode ultrasound images were used to measure CIMT. Conventional and tissue Doppler measurements were performed according to the recommendations of the American Society of Echocardiography.

RESULTS

Low ABI, mitral ratio of the early (E) to late (A) ventricular filling velocities, septal E', septal S', lateral E', lateral S', septal E'/septal A', lateral E'/lateral A', and high septal A', mitral E/septal E', mitral E/lateral E', and CIMT values were observed in the schizophrenia group compared with the control group.

CONCLUSION

Doppler parameters supported the hypothesis that patients with schizophrenia are at high risk for cardiovascular diseases.

摘要

背景

与非精神分裂症人群相比,精神分裂症患者患心血管疾病的风险更高,这与早期死亡率相关。在无症状期早期诊断精神分裂症患者的心血管疾病将提高他们的生活质量并降低死亡率。超声心动图、颈动脉超声检查和踝臂指数(ABI)测量已被证明是检测亚临床心血管疾病和风险分层的有益方法。本研究调查了精神分裂症患者与对照组相比的颈动脉内膜中层厚度(CIMT)和 ABI 以及常规和组织多普勒超声心动图测量的超声心动图参数。

方法

本病例对照研究纳入了 116 名精神分裂症患者和 88 名健康患者。排除了任何当前共患精神障碍、当前或终身神经和医学问题、当前冠心病、糖尿病、高血压、甲状腺功能减退症、甲状腺功能亢进症或正在使用抗高血压药、降糖药或减肥药的患者。使用高分辨率 B 型超声图像测量 CIMT。根据美国超声心动图学会的建议进行常规和组织多普勒测量。

结果

与对照组相比,精神分裂症组的低 ABI、二尖瓣早期(E)与晚期(A)心室充盈速度比值、间隔 E'、间隔 S'、侧壁 E'、侧壁 S'、间隔 E'/间隔 A'、侧壁 E'/侧壁 A'和高间隔 A'、二尖瓣 E/间隔 E'、二尖瓣 E/侧壁 E'和 CIMT 值较低。

结论

多普勒参数支持这样一种假设,即精神分裂症患者患心血管疾病的风险较高。

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