925例精神科患者的药品不良反应分析

Analysis of Adverse Drug Reactions in 925 Psychiatric Patients

目的:了解精神科患者药品不良反应(adverse drug reaction,ADR)发生的特点及规律,为临床安全用药提供理论依据。方法:对2015年1月—2019年8月无锡市精神卫生中心上报的925例发生ADR的精神科患者资料进行统计分析,分析患者基本资料、主要怀疑药品及其分类、ADR累及器官和(或)系统及主要临床表现、ADR因果关联性及转归等。结果:925例发生ADR的精神科患者中,>60岁患者所占比例最高(323例,占34.92%);患者的原患疾病以精神分裂症为主(562例,占60.76%)。主要怀疑药品共引发ADR共1044例次,以抗精神病药为主,其中奥氮平致ADR例次数所占比例最高(171例次,占16.38%)。ADR共累及器官和(或)系统1072例次,主要累及神经系统(239例次,占22.29%),临床表现以锥体外系病为主。经过治疗,925例发生ADR的患者中,好转587例,占63.46%。结论:临床应加强对精神科患者的用药监测,出现ADR后应及时减量、停药,以确保患者用药安全、有效。

OBJECTIVE:To investigate the characteristics and regularities of adverse drug reactions(ADR)occurred in psychiatric patients,so as to provide theoretical references for clinical safe medication.METHODS:Data of ADR cases in 925 psychiatric patients reported from Jan.2015 to Aug.2019 were collected and analyzed in terms of patients’general information,main suspected drugs and its classification,ADR involved organs and(or)systems and main clinical manifestation,the causal correlation and outcomes.RESULTS:Among the 925 psychiatric patients with ADR,mostly were aged>60(323 cases,34.92%);the primary diseases of patients were mainly schizophrenia(562 cases,60.76%).The main suspected drugs had induced 1044 case-times of ADR,mainly concentrated in antipsychotic drugs,of which olanzapine had induced the most ADR(171 case-timss,16.38%).There were 1072 case-times of ADR involved organs and(or)systems,mainly involved the neurological system(239 case-times,22.29%),and the clinical manifestations were mainly extrapyramidal diseases.Of the 925 patients with ADR,587 patients turned better after treatment,including 63.46%.CONCLUSIONS:Medication monitoring on psychiatric patients should be strengthened,dosage reduction and drug withdrawl should be timely conducted when ADR occurred to ensure safe and effective medication.