A Study On The Influencing Factors Of Plasma D-dimer In Schizophrenia Patients

Background:Schizophrenia is a kind of severe mental illness with obvious aboriginality in cognition,emotion,and volitional activities.Previous studies have shown that schizophrenia itself and related treatment measures will increase the risk of thrombotic diseases.In recent years,there have been more and more case reports of arteriovenous thrombosis in patients with schizophrenia,which has attracted clinical attention.At present,there is no systematic and convenient preventive measures for thrombotic diseases in hospitalized patients with schizophrenia.Most of them are screened for blood coagulation indicators,D-dimer,and vascular ultrasound after symptoms appear.Prevention and timely treatment of outpatients are more difficult to implement,which may lead to delayed diagnosis and treatment with irreversible consequences.Objective:We investigated the risk factors affecting plasma D-dimer levels in schizophrenia by comparing the differences in plasma D-dimer levels in schizophrenia patients of different gender,age and body mass indexe,and the correlation between fasting blood glucose,blood lipids,prolactin and D-dimer in patients.By comparing the plasma D-dimer levels of patients taking different antipsychotics,the effects of different antipsychotics on plasma D-dimer levels were explored.In this way,we can indirectly find the index that may predict the risk of thrombosis in patients with schizophrenia,which can provide clinical basis for the prevention and effective intervention of thrombotic diseases,and provide guidance for clinical medication.Methods:Patients with schizophrenia who met the ICD-10diagnostic criteria and were admitted to Canning Hospital in Shenzhen City between May 2021 and December 2021 were selected.They were over 18 years old,and excluded alcohol or other psychoactive substance abuse or addiction,pregnant,lactating women,cancer patients,patients with major surgery and trauma history within 3 months,and any recent medication affecting the blood system.Fasting venous blood was collected from all patients on the morning of the second day of admission,and fasting blood glucose,blood lipid,prolactin,D-dimer and other indicators were measured.The gender,age,height,weight,whether the first episode,and the use of antipsychotic drugs within three months were recorded.The collected data was analyzed by SPSS26.0 statistical software.Non-parametric test was used for comparison between groups.The results are expressed as median（quartile range）,and P<0.05 was considered statistically significant.Spearman correlation analysis was used to analyze the correlation between variables,and P<0.05 was considered to be significant.Results:1.The median value of plasma D-dimer in female schizophrenia patients is higher than that in male schizophrenia patients（290.00 ng/ml,220.00 ng/ml）,and the difference is statistically significant（P<0.05）.2.The quartile range of D-dimer in the elderly schizophrenia group（age≥60 years old）is higher than that in the young and middle-aged group（age<60 years old）（583.00 ng/ml,150.00 ng/ml）,and the difference is statistically significant（P<0.05）.3.The median of D-dimer in the BMI≥24.0kg/m~2group is higher than that in the BMI<24.0kg/m~2group（300.00 ng/ml,245.00 ng/ml）,the difference is statistically significant（P<0.05）.4.There is no significant difference in D-dimer between patients with first-episode schizophrenia and recurrent patients（P>0.05）.5.There is a positive correlation between plasma D-dimer level and fasting blood glucose in patients with schizophrenia,ρ=0.265,and the correlation was statistically significant（P<0.05）.6.There is a positive correlation between plasma D-dimer level and total cholesterol,low-density lipoprotein cholesterol in patients with schizophrenia（ρ=0.259,0.291）,and the correlation is statistically significant（P<0.05）.The plasma D-dimer level in patients with schizophrenia is not correlated with triglyceride high-density lipoprotein cholesterol（P>0.05）.7.There is a positive correlation between plasma D-dimer level and prolactin in patients with schizophrenia,ρ=0.245,and the correlation is statistically significant（P<0.05）.8.There is no significant difference in plasma D-dimer levels among schizophrenic patients who used different types of single antipsychotic within three months（P>0.05）.Conclusion:1.The plasma D-dimer level of female patients with schizophrenia is higher than that of male patients,and the plasma D-dimer level of elderly patients with schizophrenia is higher than that of young and middle-aged patients,which are more likely to have thrombotic diseases.2.The plasma D-dimer level of overweight and obese patients with schizophrenia is higher than that of thin and normal patients,which are more likely to get thrombotic diseases.3.The level of plasma D-dimer in patients with schizophrenia is positively correlated with fasting blood glucose,total cholesterol,low density lipoprotein cholesterol and prolactin.Patients with high blood glucose,blood lipids and prolactin are more likely to have thrombotic diseases.4.Plasma D-dimer level is not correlated with triglyceride and high density lipoprotein cholesterol in patients with schizophrenia.5.There is no significant difference in plasma D-dimer levels between first-episode and recurrent schizophrenic patients.6.The plasma D-dimer level in patients with schizophrenia is not related to the types of antipsychotic drugs used within three months.7.This study analyzed the demographic characteristics and laboratory indexes of patients with schizophrenia,and proved that gender,age,fasting blood glucose,blood lipid and prolactin could affect the plasma D-dimer level of patients.These indicators may be a predictor of thrombotic risk in patients with schizophrenia.Therefore,we need to focus on key groups in clinical work and take preventive measures to reduce the risk of disease.In the future,the above indicators can be considered to make a thrombosis risk assessment model for patients with schizophrenia.