Wang Jiaoyan, Zhang Yingchun, Ren Keming, Li Yeping, Ying Kejing
Division of Pulmonary and Critical Care Medicine, Wenzhou Medical University Affiliated Taizhou Hospital, Linhai, Zhejiang, China.
Department of Pulmonary and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Front Psychiatry. 2024 May 17;15:1340138. doi: 10.3389/fpsyt.2024.1340138. eCollection 2024.
The risk of venous thromboembolism in patients with mental illness has been insufficiently addressed. This study aimed to assess the correlation between hyperhomocysteinemia and venous thromboembolism prevalence among this population.
Patients with a diagnosis of mental illness and concurrent venous thromboembolism, admitted to Sir Run Run Shaw Hospital at Zhejiang University School of Medicine between January 2014 and December 2021, were included in the venous thromboembolism group. The control group, approximately twice the size, comprised individuals with mental illness but without venous thromboembolism. Basic clinical data were gathered for both cohorts.
In psychiatric patients, elevated D-dimer levels(OR=5.60,95% CI 3.28-10.00), hyperhomocysteinemia (OR=2.37,95% CI 1.10-5.14), and hyperprolactinemia(OR= 2.68,95% CI 1.12-6.42)were significant risk factors for venous thromboembolism. According to further subgroup analyses, hyperhomocysteinemia is a significant risk factor associated with pulmonary embolism, with an OR of 5.08 (95% CI 1.20-21.48). An interaction effect between gender and homocysteine level was found, with a p-interaction of 0.022. A subsequent analysis confirmed the association between hyperhomocysteinemia and venous thromboembolism in female psychiatric patients, with an OR of 3.34 (95% CI 1.68-6.65), indicating that hyperhomocysteinemia is a significant risk factor for venous thromboembolism in women.
Patients with psychiatric disorders were found to have an elevated risk of venous thromboembolism, which was associated with increased levels of D-dimer, hyperprolactinemia, and hyperhomocysteinemia. A strong correlation between hyperhomocysteinemia and pulmonary embolism was identified in patients with mental illnesses. Furthermore, the study revealed that female psychiatric patients with hyperhomocysteinemia constituted a high-risk group for venous thromboembolism. This finding holds significant clinical implications, suggesting that early preventative measures could be implemented for this high-risk population to reduce the incidence of thromboembolic events during hospitalization for psychiatric patients.
精神疾病患者发生静脉血栓栓塞的风险尚未得到充分研究。本研究旨在评估该人群中高同型半胱氨酸血症与静脉血栓栓塞患病率之间的相关性。
纳入2014年1月至2021年12月期间在浙江大学医学院附属邵逸夫医院住院的精神疾病合并静脉血栓栓塞患者作为静脉血栓栓塞组。对照组人数约为静脉血栓栓塞组的两倍，由患有精神疾病但未发生静脉血栓栓塞的个体组成。收集两组的基本临床数据。
在精神科患者中，D-二聚体水平升高（OR=5.60，95%CI 3.28-10.00）、高同型半胱氨酸血症（OR=2.37，95%CI 1.10-5.14）和高催乳素血症（OR=2.68，95%CI 1.12-6.42）是静脉血栓栓塞的显著危险因素。进一步的亚组分析显示，高同型半胱氨酸血症是与肺栓塞相关的显著危险因素，OR为5.08（95%CI 1.20-21.48）。发现性别与同型半胱氨酸水平之间存在交互作用，p交互值为0.022。随后的分析证实，高同型半胱氨酸血症与女性精神科患者的静脉血栓栓塞相关，OR为3.34（95%CI 1.68-6.65），表明高同型半胱氨酸血症是女性静脉血栓栓塞的显著危险因素。
精神疾病患者发生静脉血栓栓塞的风险升高，这与D-二聚体水平升高、高催乳素血症和高同型半胱氨酸血症有关。在精神疾病患者中，高同型半胱氨酸血症与肺栓塞之间存在强相关性。此外，研究表明，高同型半胱氨酸血症的女性精神科患者是静脉血栓栓塞的高危人群。这一发现具有重要的临床意义，提示可对这一高危人群采取早期预防措施，以降低精神科患者住院期间血栓栓塞事件的发生率。
