2015年-2019年抑郁障碍住院患者抗抑郁药物使用情况分析

Analysis on the use of antidepressants in inpatients with depression from 2015 to 2019

目的调查2015年-2019年抑郁障碍住院患者抗抑郁药物使用情况,了解药物种类和治疗方案的变化,为临床用药提供参考。方法利用京津冀精神卫生大数据平台,对2015年-2019年在首都医科大学附属北京安定医院住院的抑郁障碍患者相关数据进行回顾性分析,描述患者抗抑郁药物种类和用药方案的变化情况。结果 2015年-2019年,符合条件的患者共6 043例。抗抑郁药物使用种类方面,选择性5-羟色胺再摄取抑制剂(SSRIs)类中的舍曲林、西酞普兰、氟西汀处方比例呈下降趋势(P<0.05或0.01),艾司西酞普兰处方比例呈波动趋势(P=0.031);5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRIs)类中的度洛西汀和米那普仑处方比例呈上升趋势(P均<0.01),新药阿戈美拉汀(P=0.001)、伏硫西汀(P<0.01)处方比例也呈上升趋势。从用药方案上看,单一使用抗抑郁药、两种抗抑郁药联合使用比例均呈下降趋势(P均<0.01),抗抑郁药联合心境稳定剂、抗抑郁药联合心境稳定剂及抗精神病药物使用比例呈上升趋势(P<0.05或0.01)。结论五年间住院抑郁障碍患者抗抑郁药物种类分布呈现SSRIs类药物相对比例下降、SNRIs类药物及新药相对比例上升,治疗方案中抗抑郁药联合心境稳定剂及抗精神病药物处方比例呈上升趋势。

Objective to 2019,and to analyze the changes of these antidepressants and medication regimens,so as to provide references for clinical drug use.MethodsUsing the Beijing-Tianjin-Hebei big data platform,the data of patients with depression in Beijing Anding Hospital,Capital Medical University from 2015 to 2019 were retrospectively analyzed.The changes of different types of drugs and medication regimens were described.Results selective serotonin reuptake inhibitors(SSRIs),the prescription proportion of sertraline,citalopram and fluoxetine showed a trend of decline(P<0.05 or 0.01),while the prescription proportion of escitalopram showed a trend of fluctuations(P=0.031).In serotonin noradrenaline reuptake inhibitors(SNRIs),the prescription proportion of duloxetine and milnacipran were rising(P<0.01).The newer antidepressants agomelatine(P=0.001)and voltioxetine(P<0.01)also showed an upward trend.In terms of medication regimen,the proportion of single antidepressants and combined use of two antidepressants showed a downward trend(P<0.01),while the proportion of antidepressants combined with mood stabilizers,antidepressants combined with mood stabilizers or antipsychotics showed an upward trend(P<0.05 or 0.01).ConclusionIn the 5 years,the proportion of SSRIs decreased,and the proportion of SNRIs and newer antidepressants increased in hospitalized patients with depression.The proportion of antidepressants combined with mood stabilizers and antipsychotics in treatment regimens showed an increasing trend.