接受改良电休克治疗的精神分裂症患者医院获得性肺炎影响因素的性别差异
Sex differences in factors influencing hospital-acquired pneumonia in schizophrenia patients receiving modified electroconvulsive therapy.
作者信息
Yang Mi, Yang Yan, Liu Liju, Kong Di, Xu Min, Huang Xincheng, Luo Cheng, Zhao Guocheng, Zhang Xiangyang, Huang Yan, Tu Yunzhong, Li Zezhi
机构信息
Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China.
The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
出版信息
Front Psychiatry. 2023 Feb 14;14:1127262. doi: 10.3389/fpsyt.2023.1127262. eCollection 2023.
BACKGROUND
Sex differences may be presented in the clinical features or symptoms of schizophrenia patients but also affect the occurrence of hospital-acquired pneumonia (HAP). Modified electroconvulsive therapy (mECT) is a common treatment method for schizophrenia, used in combination with antipsychotics. This retrospective research explores the sex difference in HAP affecting patients with schizophrenia who have received mECT treatment during hospitalization.
METHODS
We included schizophrenia inpatients treated with mECT and antipsychotics between January 2015 and April 2022. Blood-related and demographic data collected on admission were analyzed. Influencing factors of HAP in male and female groups were assessed separately.
RESULTS
A total of 951 schizophrenia patients treated with mECT were enrolled in the study, including 375 males and 576 females, of which 62 patients experienced HAP during hospitalization. The risk period of HAP in these patients was found to be the first day after each mECT treatment and the first three sessions of mECT treatment. Statistically significant differences in the incidence of HAP were identified in male vs. female groups, with an incidence in men about 2.3 times higher than that in women ( < 0.001). Lower total cholesterol ( = -2.147, = 0.032) and the use of anti-parkinsonian drugs (χ = 17.973, < 0.001) were found to be independent risk factors of HAP in male patients, while lower lymphocyte count ( = -2.408, = 0.016), hypertension (χ = 9.096, = 0.003), and use of sedative-hypnotic drugs (χ = 13.636, < 0.001) were identified in female patients.
CONCLUSION
Influencing factors of HAP in schizophrenia patients treated with mECT have gender differences. The first day after each mECT treatment and the first three sessions of mECT treatment were identified to have the greatest risk for HAP development. Therefore, it would be imperative to monitor clinical management and medications during this period according to these gender differences.
背景
性别差异可能体现在精神分裂症患者的临床特征或症状中，也会影响医院获得性肺炎（HAP）的发生。改良电休克治疗（mECT）是精神分裂症的一种常见治疗方法，常与抗精神病药物联合使用。这项回顾性研究探讨了HAP在住院期间接受mECT治疗的精神分裂症患者中的性别差异。
方法
我们纳入了2015年1月至2022年4月期间接受mECT和抗精神病药物治疗的精神分裂症住院患者。对入院时收集的血液相关和人口统计学数据进行分析。分别评估男性和女性组中HAP的影响因素。
结果
共有951例接受mECT治疗的精神分裂症患者纳入研究，其中男性375例，女性576例，其中62例患者在住院期间发生HAP。这些患者发生HAP的风险期为每次mECT治疗后的第一天以及mECT治疗的前三疗程。男性和女性组中HAP的发生率存在统计学显著差异，男性发生率约为女性的2.3倍（<0.001）。较低的总胆固醇（=-2.147，=0.032）和使用抗帕金森药物（χ=17.973，<0.001）被发现是男性患者发生HAP的独立危险因素，而较低的淋巴细胞计数（=-2.408，=0.016）、高血压（χ=9.096，=0.003）和使用镇静催眠药物（χ=13.636，<0.001）在女性患者中被识别出。
结论
接受mECT治疗的精神分裂症患者中HAP的影响因素存在性别差异。每次mECT治疗后的第一天以及mECT治疗的前三疗程被确定为发生HAP的风险最大。因此，在此期间根据这些性别差异监测临床管理和用药至关重要。
Zotero 插件