苏州市精神分裂症患者抗精神病药物使用现况调查

Survey of antipsychotic drugs using status in patients with schizophrenia in Suzhou

目的:调查苏州市精神分裂症患者抗精神病药物使用现况。方法:采用患者药物使用调查表,对苏州市3家精神疾病专科医院的544例住院和门诊精神分裂症患者进行抗精神病药物使用情况调查。结果:使用居前6位的抗精神病药物分别是氯氮平(25.6%)、利培酮(16.5%)、奥氮平(13.9%)、奎硫平(11.4%)、阿立哌唑(9.1%)、氯丙嗪(6.8%)。门诊和住院患者抗精神病药物使用频率存在差异(χ2=37.361,P=0.003)。门诊患者氯氮平、利培酮、奥氮平、奎硫平、阿立哌唑、氯丙嗪、奋乃静、帕利哌酮的使用剂量低于住院患者;舒必利、齐拉西酮、氟哌啶醇使用剂量高于住院患者(P均<0.01)。单一抗精神病药治疗的比率(54.4%,293例)高于联合药物治疗(45.6%,246例);单一药物治疗者中84.2%(247例)使用第2代抗精神病药(SGAs);联合用药者中97.8%(241例)主要抗精神病药物及65.0%(160例次)次要药物为SGAs;最常合并使用的药物是镇静催眠药(20.2%)、心境稳定剂(12.2%)、抗胆碱能药(12.1%)、抗抑郁药(7.8%)和β-受体阻断剂(4.3%)。结论:单一用药和选择SGAs是苏州市精神分裂症患者药物治疗的主要方式。

Objective： To investigate the status quo of antipsychotic drugs using in patients with schizophrenia in Suzhou. Method： The drugs using questionnaire was used to investigate the drug using situation in544 schizophrenic patients（ including inpatients and outpatients） from 3 mental disease hospitals in Suzhou.Results： The first 6 drugs used frequently were clozapine（ 25. 6%）,risperidone（ 16. 5%）,olanzapine（ 13. 9%）,quetiapine（ 11. 4%）,aripiprazole（ 9. 1%） and chlorpromazine（ 6. 8%）. The usage frequency of antipsychotic was significantly different between inpatients and outpatients（ χ^2= 37. 361,P = 0. 003）. Compared with inpatients,the dose of clozapine,risperidone,olanzapine,quetiapine,aripiprazole and chlorpromazine in outpatients were significantly lower,sulpiride,ziprasidone and haloperidol were significantly higher（ all P〈0. 01）. The rate of using single antipsychotic drug（ 54. 4%,293 cases） was higher than combination（ 45. 6%,246 cases）. Among the patients treated with single antipsychotic drug,84. 2%（ 247 cases） used the second generation antipsychotics（ SGAs）; and among the patients treated with combination therapy,97. 8%（ 241 cases）main drug and 65. 0%（ 160 cases） secondary drugs were SGAs. The most common combinative drugs were sedative hypnotics（ 20. 2%）,then mood stabilizers（ 12. 2%）,anticholinergics（ 12. 1%）,antidepressants（ 7. 8%） and β-blockers（ 4. 3%）. Conclusion： The major treatment model of schizophrenia in Suzhou is using single antipsychotic drug and choosing SGAs.