【摘要】目的：探讨慢性精神病患者猝死的相关因素。方法： 选取1995年1月至2005年12月在本院住院治疗过程中发生猝死的28例精神病患者作为猝死组，以2006年3月1日所在本院的729例精神病患者作为对照组。收集两组病例的相关临床资料(性别、年龄、服药时间、伴发躯体症状、精神障碍种类、抗精神病药种类及剂量、心电图特征、QTc间期等)；对猝死组收集死因的临床判断，死亡季节及可能与猝死有关的资料。结果：猝死患者占同期住院患者的3.08‰，猝死组与对照组患者平均年龄、总病程、用药时间之间无差异性(P>0.05)；两组在抗精神病药剂量及服用氯氮平者QTc之间均无显著性(P>0.05)；两组总体QTc，即猝死组(418.39±21.86)与对照组(402.83±26.4)，差异有非常显著性意义(P=0.00)；两组QTc服氯氮平组(399.84±23.22)与非氯氮平组(412.38±28.7)存在差异性。猝死组用典型药物(64.3%)多于对照组(36.08%；P<0.01)；猝死组心电图异常者(71.4%)多于对照组(36.35%；P<0.01)。猝死好发于冬季，大多发生于入院3月内者(25.0%)和大于8年者(53.6%)，主要死于心源性猝死(64.3%)。结论：心电图异常、用非典型药物治疗、冬季、入院小于3月或大于8年者等可能是慢性精神病患者发生猝死的相关因素。

     【关键词 】 慢性疾病;精神病;猝死;心电图描记

    Correlatet factors of sudden death in chronic psychotic inpatients

    ZHU Hong, LIN Li-qun. ZHANG Xiao -yun

    (Nanjing Qinglongshan mental hospital,Nanjing 211123 Jiangsu)

    【Abstract】Objective：To study relative risk factorsof sudden death in chronic psychotic inpatients. Methods:Select by examinations January of 1995 take place 28 mental illnesses of sudden death stayed in the hospital cure process December to the 2005 conduct and actions sudden death set, with 2006 March 1 729 mental illnesses of place my hospital conduct and actions matched control. Collect the related and clinical data of two cases;( sex, age, medicine time, co-morbid physical disease, spirit obstacle category,type of psychotic,type and dosage of antipsychotics,electrocardiogram(ECG) characteristic, QTc interval etc.) To the sudden death set collections die from clinical judgment, death season and possibility and data of relevant sudden death.Results: Sudden death inpatients shares the same period stays in the hospital psychotic inpatients of 3.08 ‰ . Two total QTcs, then sudden death set(418.39±21.86) with matched control(402.83±26.4), the difference has to show the meaning of very much( P=0.00). Two QTcs in clozapine treatment set and no clozapine treatment set exsits difference. The sudden death set uses the precious sight more matched control in medicine(64.3%) in typical model(36.08%; P<0.01). Sudden death an electrocardiogram abnormality(71.4%) precious sight more matched control(36.35%; P<0.01).Conclusions: ECG abnormality, use not typical model medicine treatment, winter, hospitalize smaller March or 8 years of larger etc may be the risk factors of sudden death in psychoic patients. ......