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。

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.