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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >The association between carotid atherosclerosis and treatment with lithium and antipsychotics in patients with bipolar disorder
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The association between carotid atherosclerosis and treatment with lithium and antipsychotics in patients with bipolar disorder

机译：双相障碍患者颈动脉粥样硬化与锂和抗精神病学治疗的关联

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Objectives: Patients with bipolar disorder are at high risk of cardiovascular diseases. Among cardiovascular diseases, coronary heart disease and stroke are the leading causes of premature death and both share the pathogenesis of arterial atherosclerosis. Increased carotid intima-media thickness is sensitive for detecting early atherosclerosis and a practical index for predicting cardiovascular diseases. However, few studies investigated carotid intima-media thickness in adults with bipolar disorder. We attempted to determine the factors associated with carotid intima-media thickness in adults with bipolar disorder. Methods: The euthymic out-patients with bipolar I disorder aged over 20 years were recruited to measure the carotid intima-media thickness value through B-mode carotid ultrasound. Those with any psychiatric disorder, acute or life-threatening medical condition were excluded. All clinical information was obtained by reviewing medical records and directly interviewing patients with reliable others. Results: Of the 106 participants with a mean age of 44.5 years, 40.6% (N = 43) had concurrent cardiovascular/endocrine/metabolic diseases. A multivariate regression indicated that higher assumed daily lithium dosage was significantly associated with a decreased carotid intima-media thickness in the whole sample. In the young subgroup (<= 45 years old,N = 63), higher current daily lithium dosage and lower body mass index were associated with lower carotid intima-media thickness. In those without concurrent cardiovascular/endocrine/metabolic diseases, higher ratio of first-generation antipsychotics exposure in relation to illness chronicity was associated with higher carotid intima-media thickness, after controlling for body mass index or age. Conclusion: Lithium treatment may be associated with less progression in carotid intima-media thickness and the reduced risk for atherosclerosis in adults with bipolar disorder, including those with high cardiovascular disease risk. In addition to age and body mass index, antipsychotics may increase carotid intima-media thickness even in the low cardiovascular disease-risk patients.
机译：目的：双相情感障碍患者患心血管疾病的风险很高。在心血管疾病中，冠心病和中风是导致过早死亡的主要原因，两者都有动脉粥样硬化的发病机制。颈动脉内膜中层厚度增加对早期动脉粥样硬化的检测是敏感的，也是预测心血管疾病的实用指标。然而，很少有研究调查成人双相情感障碍患者的颈动脉内膜-中层厚度。我们试图确定成人双相情感障碍患者颈动脉内膜中层厚度的相关因素。方法：采用B型颈动脉超声检测20岁以上双相I型障碍患者的颈动脉内膜-中层厚度。排除患有任何精神障碍、急性或危及生命的疾病的患者。所有临床信息都是通过查阅病历和直接与可靠的其他人面谈获得的。结果：在平均年龄为44.5岁的106名参与者中，40.6%（N=43）同时患有心血管/内分泌/代谢疾病。多元回归分析表明，在整个样本中，较高的假定每日锂剂量与颈动脉内膜-中层厚度降低显著相关。在年轻组（<=45岁，N=63），较高的每日锂剂量和较低的体重指数与较低的颈动脉内膜-中层厚度相关。在那些没有并发心血管/内分泌/代谢疾病的患者中，在控制体重指数或年龄后，第一代抗精神病药物暴露与疾病慢性相关的比例越高，颈动脉内膜-中层厚度越高。结论：锂治疗可能与双相情感障碍成人（包括心血管疾病高危人群）颈动脉内膜-中层厚度的进展减少和动脉粥样硬化风险降低有关。除年龄和体重指数外，抗精神病药物可能会增加颈动脉内膜-中层厚度，即使在心血管疾病风险较低的患者中也是如此。

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