首发精神分裂症患者首次用药情况分析

Analysis of First Drug Use in First-episode Schizophrenics

目的:了解门诊首发精神分裂症患者首次用药情况。方法:选取2016年3月至7月、2017年2月至6月、2018年1月至5月在我院门诊首次治疗的精神分裂症患者共计180例,依次分为A组74例、B组50例、C组56例。自拟调查表并对符合条件的研究对象进行调查,了解病情、社会人口学资料以及用药情况。分析比较调查结果。结果:单用抗精神病药物(APD)者A、B、C三组比较,氯氮平、舒必利在单用APD中的使用率呈明显下降趋势(P<0.05),利培酮在单用APD中的使用率仍然较高,但阿立哌唑已成为目前首次治疗单用APD的首选药物。联用两种APD者A组20例(27.03%);B组11例(22.00%),其中B组仍有联用1种APD者1例(2.00%);C组10例(17.86%)。B、C组联用APD者明显减少。三组间的差异极显著(χ^2=37.73,P<0.05)。C组单用一种APD(46例,占82.14%)均明显高于A、B组(分别为54例、39例,占72.97%、78.00%),联用APD下降较快,三组间差异显著(P<0.05);A、B、C三组合用安坦率分别为14%、12%、8%。三组间差异无显著性(P>0.05);A、B、C三组合用BZD率分别为34%、41%、55%;传统APD使用频度明显下降,而新型非典型APD使用频度较高。结论:目前对于门诊首发精神分裂症患者的首选治疗方法是单独使用阿立哌唑,同时谨慎合用安坦和BZD。

Objective:To understand the first use of drugs in outpatients with schizophrenia.Methods:A total of 180 schizophrenics who were first treated in our hospital from March to July 2016,February to June 2017 and January to may 2018 were divided into group A(74 cases),group B(50 cases)and group C(56 cases).We designed a questionnaire and investigated the eligible subjects to understand the condition,social demographic data and drug use.Analyze and compare the survey results.Results:Compared with a group,B group and C group,the use rate of clozapine and sulpiride in APD group decreased significantly(P<0.05),and the use rate of risperidone in APD group was still high,but aripiprazole has become the first drug of choice.20 cases(27.03%)in group A,11 cases(22.00%)in group B,1 case(2.00%)in group B and 10 cases(17.86%)in group C.The combination of APD in group B and C decreased significantly.The difference between the three groups was significant(χ^2=37.73,P<0.05).The APD of group C(46 cases,accounting for 82.14%)was significantly higher than that of group A and group B(54 cases,39 cases,accounting for 72.97%and 78.00%,respectively).The APD of group C decreased rapidly,and the difference among the three groups was significant(P<0.05).The ratio of combination a,B and C was 14%,12%and 8%,respectively.There was no significant difference among the three groups(P>0.05);the BZD rate of a,B and C combination was 34%,41%and 55%respectively;the frequency of traditional APD decreased significantly,while the frequency of new atypical APD was higher.Conclusion:At present,the first choice for outpatients with first-episode schizophrenia is to use aripiprazole alone,at the same time,use Antan and BZD cautiously.