长期服用第二代抗精神病药物的精神分裂症患者肝损伤程度的危险因素分析及预测模型构建OA
Analysis of Risk Factors and Construction of Prediction Model for Liver Injury in Schizophrenia Patients Taking Long-Term Second-Generation Antipsychotics
目的:分析长期服用第二代抗精神药物的精神分裂症患者肝损伤程度的危险因素,并构建重度肝损伤的风险预测模型.方法:回顾性分析 2023年1月～2024年12 月本院收治的80 例精神分裂症患者的临床资料,根据肝损伤程度分为轻度组(n=41)、中度组(n=25)、重度组(n=14).比较三组患者临床各项资料[性别、年龄、体质量指数(BMI)、病程、精神分裂症亚型、糖尿病、高血压、冠心病、饮酒史、吸烟史、贫血、营养不良、药物服用种类],将单因素分析中具有统计学差异的指标纳入 Logistic 回归模型.根据回归系数拟合的联合数据,采用受试者工作特征(ROC)曲线构建重度肝损伤的风险预测模型.结果:单因素分析结果显示,年龄、BMI、病程、饮酒史、营养不良、药物服用种类是影响肝损伤程度的主要可疑危险因素.进一步 Logistic 回归分析结果显示,BMI、营养不良、药物服用种类是导致重度肝损伤的独立危险因素(P＜0.05).根据 Logistic 回归系数拟合的联合模型,进行 ROC 曲线分析显示,曲线下面积(AUC)为 0.892、预测敏感度为 99.2%、特异度为 78.8%;预测精度为 50.0%、召回率为99.5%;预测概率为0.82.结论:年龄、BMI、病程、饮酒史、营养不良、药物服用种类是长期服用第二代抗精神病药物的精神分裂症患者肝损伤程度的主要可疑危险因素,其中 BMI、营养不良、药物服用种类是重度肝损伤的独立危险因素.临床应对上述因素加强监测与管理,以减少药物性肝损伤的发生.
Objective:To analyze the risk factors for the degree of liver injury in schizophrenia patients taking long-term second-generation antipsychotics,and to construct a risk prediction model for severe liver injury.Methods:Clinical data of 80 schizophrenia patients admitted to our hospital from January 2023 to December 2024 were retrospectively analyzed.According to the degree of liver injury,they were divided into mild group(n=41),moderate group(n=25)and severe group(n=14).Clinical data including gender,age,body mass index(BMI),disease duration,schizophrenia subtype,diabetes,hypertension,coronary heart disease,drinking history,smoking history,anemia,malnutrition and types of drugs were compared among the three groups.Indicators with statistical significance in univariate analysis were included in Logistic regression model.Receiver operating characteristic(ROC)curve was used to construct a risk prediction model for severe liver injury based on the combined data fitted by regression coefficients.Results:Univariate analysis showed that age,BMI,disease duration,drinking history,malnutrition and types of drugs were the main suspected risk factors affecting the degree of liver injury.Further Logistic regression analysis showed that BMI,malnutrition and types of drugs were independent risk factors for severe liver injury(P<0.05).ROC curve analysis of the combined model showed that the area under the curve(AUC)was 0.892,the prediction sensitivity was 99.2%,the specificity was 78.8%,the prediction accuracy was 50.0%,the recall rate was 99.5%,and the prediction probability was 0.82.Conclusion:Age,BMI,disease duration,drinking history,malnutrition and types of drugs are the main suspected risk factors for liver injury in schizophrenia patients taking long-term second-generation antipsychotics,among which BMI,malnutrition and types of drugs are independent risk factors for severe liver injury.Clinical monitoring and management of the above factors should be strengthened to reduce the occurrence of drug-induced liver injury.
赵中健;刘文静;刘志华;朱俊敬
郑州市第八人民医院心境障碍二科,郑州 450006郑州市第八人民医院心境障碍二科,郑州 450006郑州市第八人民医院心境障碍二科,郑州 450006郑州市第八人民医院心境障碍二科,郑州 450006
医药卫生
长期服用第二代抗精神病药物精神分裂症肝损伤危险因素预测模型
long-term administrationsecond-generation antipsychoticsschizophrenialiver injuryrisk factorsprediction model
《中国合理用药探索》 2026 (5)
135-140,6
2024年度郑州市医学科研项目(ZZYK2024067)
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