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  • 學位論文

思覺失調症患者增加罹患失智症 風險及失智症影響因素之探討

Risk and determined factars of developing Dementia in patients with Schizophrenia

指導教授 : 邱政元

摘要


背景:隨著全球人口老化,醫療科技的進步,老年人口不斷增加,思覺失調症及失智症人口快速增加。世界衛生組織於2012年4月發佈的全球失智症報告中,估計2010年全球有3560萬的失智症患者,以每年增加770萬人的速度成長,即約每4秒鐘就有一名新罹病者。根據文獻指出思覺失調症患者可能因罹患高血壓、糖尿病、高血脂、心血管疾病及代謝症候群等相關共病,且健康管理能力降低,可導致思覺失調症患者增加罹患失智症之風險。本研究利用「全民健康保險研究資料庫」分析,探討思覺失調症患者是否增加罹患失智症風險暨失智症影響因素。 目的:思覺失調症與失智症在精神科醫學領域中是最重要的疾病,本研究主要探討思覺失調症與失智症現況與相關因素,及思覺失調症病患老年時是否增加罹患失智症之風險。 方法:本研究使用2005年百萬歸人檔為從全民健康保險資料隨機選取100萬人具樣本代表性大型資料,本研究使用該資料庫從2000年到2010年所有就醫資料本研究進行病例對照研究(case-control study),以年齡、性別及共病等進行配對,配對後實驗組為8497人,對照組有33988人。以SPSS 18.0進行描述性統計以及條件式邏輯斯迴歸分析思覺失調症患者增加罹患失智症之風險。 結果:研究結果顯示失智症患者在性別、罹患思覺失調症、腦血管疾病、慢性肝疾病、糖尿病、高血壓、高脂血症及酒精性疾病皆有顯著差異性。統計結果顯示患者患有共病及思覺失調症會增加罹患失智症風險。且將是否患有腦血管疾病、慢性肝疾病、糖尿病、高血壓、高脂血症及酒精性疾病,納入作為控制變項時,思覺失調症患者也會顯著增加罹患失智症之風險,風險為3.84倍。我們可以發現,65歲以下思覺失調症患者會顯著加罹患失智症之風險,且風險高於65歲以上族群。在年齡層當中,以50-59歲之風險最高。男性思覺失調症患者會顯著加罹患失智症之風險,且風險高於女性族群。 結論:本研究發現思覺失調症患者會增加罹患失智症的風險,尤其患者患有慢性疾病會增加罹患失智症的風險,台灣高齡社會化,晚年生活思覺失調患者及失智症患者不斷增加,應及早發現早期診斷與治療。

並列摘要


Background:As the global population aging, advances in medical technology, the elderly population is growing ensue a rapid increase in dementia and schizophrenia patients. World Health Organization in April 2012 report released by the Global dementia, estimated in 2010 of 35.6 million worldwide with dementia, with 7.7 million annual increase rate of growth, that is, about every four seconds on a new diseased person. According to the study,schizophrenia patients may got hypertension, diabetes,cerebrovascular disease , metabolic syndrome related comorbidities .And reduce healthy management ability.Schizophrenia patients will significantly increase the risk of dementia,In this study, we use"National Health Insurance Research Database" to analyzethat if schizophrenia patient will developdementia or not.Schizophrenia patients will significantly increase the risk of dementia, Objective: Schizophrenia and dementia are important diseases in the medical field. The study was designed to investigate the risk factors of schizophrenia , related factors of dementia and whether the elderly patients with schizophrenia will increase the risks of dementia or not. Methods:The study used 2005 from the National Health Insurance data and randomly selected one million representative samples of the large-scale data .The database is from 2000 to 2010 , all the medical data of this study conducted a case-control study. By age, gender and comorbidity to pair up. After pairing , experimental group are 8497 people ,and there are 33,988 in control groupe. Conducting descriptive statistics and logistic regression with SPSS 18.0 to analyze patients with schizophrenia increasing the risks of dementia. Results:The studies showed that patients who have gender, schizophrenia, cerebrovascular disease , chronic liver disease, diabetes, hypertension, hyperlipidemia, alcoholic diseases are significant differences. Statistics showed that patients with comorbid disease and schizophrenia increases the risk of dementia.Cerebrovascular disease, chronic liver disease, diabetes, hypertension, hyperlipidemia, and alcoholic diseases, included as control variables,. Schizophrenia patients will significantly increase the risk of dementia, the risk (RR=3.84). We can find that patients who are under 65 years old will significantly increase the risk of dementia, and the risk is higher than the population over 65 years old. In ages among 50-59 ,with the highest risk. Men’s schizophrenia patients will significantly increase the risk of dementia, and the risk is higher than the female population. Conclusion:The study found that patients with schizophrenia may increase the risk of dementia, patients with chronic diseases particularly increase the risk of dementia, hyper-aged society in Taiwan, people with schizophrenia and dementia increasing. It should be early detection , giving diagnosis and treatment.

參考文獻


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張正辰(2010)。精神分裂症病患不同位置腰圍測量值與心血管疾病危險因子探討。取自華藝線上圖書館。
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