上海交通大学学报（医学版）

上海交通大学学报（医学版）

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首次诊断双相障碍患者的生存分析

陈思路1，季卫东1，方怡儒2，吴 彦2，张 伟1，高 炬1   

  1. 1.上海市长宁区精神卫生中心， 上海 200335； 2.上海交通大学医学院附属精神卫生中心， 上海 200030
  • 出版日期:2014-04-28 发布日期:2014-05-13
  • 通讯作者: 季卫东, 电子信箱: jidong1999@126.com。
  • 作者简介:陈思路（1980—）， 女， 住院医师， 硕士; 电子信箱: 7_50@sina.com。
  • 基金资助:

    上海市长宁区卫生局特色专科建设项目（2012206001）；上海市长宁区卫生局专病建设项目（2011210416）；上海市妇儿委重点项目（201208009）；上海市长宁区政府“领军人才”建设项目

Survival analysis of patients with first diagnosed bipolar disorder

CHEN Si-lu1, JI Wei-dong1, FANG Yi-ru2, WU Yan2, ZHANG Wei1, GAO Ju1   

  1. 1.Changning District Mental Health Center, Shanghai 200335, China; 2.Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Online:2014-04-28 Published:2014-05-13
  • Supported by:

    Medical Specialists Construction Project of Shanghai Changning Health Bureau, 2012206001; Special Disease Construction Project of Shanghai Changning Health Bureau, 2011210446; Key Project of Shanghai Women and Children Committee, 201208009; Leading Talent Construction Project of Changning District

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摘要：

目的 分析首次诊断双相障碍并接受药物治疗患者的生存情况及其影响因素。方法 收集785例首次诊断双相障碍患者的临床资料。采用Kaplan-Meier法绘制生存曲线，利用Cox比例风险模型对患者治疗后1年的生存状况及影响因素进行统计学分析。结果 785例患者接受药物治疗后第2.5、5、7.5、10、12.5个月时的累积生存率分别为0.98、0.96、0.95、0.94和0.65；截至随访终点，82例患者死亡，病死率10.4%；首次治疗后12个月内的病死率为4.3%。多因素Cox 回归分析结果显示：躯体疾病共病和联合抗精神病药物的治疗方案与患者生存时间有关。结论 对于首次诊断双相障碍的患者，早期联合抗精神病药物治疗可延长患者的生存时间，提高生存率；躯体疾病共病是影响患者生存的危险因素。

关键词: 双相障碍, 抗精神病药物治疗, 生存分析

Abstract:

Objective To analyze the survival and relevant influence factors of patients with first diagnosed bipolar disorder and being treated by medicines. Methods Clinical data of 785 patients with first diagnosed bipolar disorder were collected. The survival curves were plotted by the Kaplan-Meier method. The survival and influence factors were statistically analyzed by the Cox proportional hazard model for patients after being treated for one year. Results Among 785 patients, the cumulative survival rates of 2.5, 5, 7.5, 10, and 12.5 months after treatment were 0.98, 0.96, 0.95, 0.94, and 0.65, respectively. By the end of follow-up, 82 patients died and the mortality rate was 10.4%. The mortality rate during twelve months after first treatment was 4.3%. Multivariate Cox regression analysis showed that the somatic diseases and combined antipsychotic drug treatment programs were relevant to the survival time of patients. Conclusion For patients with first diagnosed bipolar disorder, early combined antipsychotic drug treatments can prolong the survival time of patients and increase the mortality rate. Somatic diseases are dangerous factors that influence the survival of patients.

Key words: bipolar disorder, antipsychotic medication therapy, survival analysis