不同起病年龄双相障碍患者的特征和用药比较

Comparison of characteristics and drug regimens in patients with bipolar disorder at different onset ages

目的:研究不同起病年龄段双相障碍患者的特征和用药情况。方法:利用电子病历系统,收集住院双相障碍患者的人口学资料、临床资料和用药情况,将患者按起病年龄分为早发型、中间型和晚发型,比较3组的人口学特征、临床特征和用药差异。结果:共纳入双相障碍患者8184例,其中早发型1575例(19.24%),中间型5383例(65.77%),晚发型1226例(14.98%)。早发型年龄更小,男性和未婚比例更高,病程和住院时间更长,混合状态的比例更高(P<0.05)。早发型使用两种心境稳定剂联合抗精神病药的比例较高,药物组合以锂盐+丙戊酸盐+喹硫平/奥氮平为主(P<0.05)。晚发型使用1种心境稳定剂联合抗精神病药的比例较高,药物组合以丙戊酸盐+喹硫平/奥氮平为主(P<0.05)。晚发型联用抗抑郁药的比例较高(P<0.05)。结论:不同年龄起病的双相障碍患者在人口学特征、临床特征和用药上均存在显著差异,双相障碍的起病年龄应引起重视。

Objective:To study the characteristics and medication regimens of patients with bipolar disorder at different age of onset.Method:The electronic medical record system was used to collect the demographic data,clinical data and drug use of patients with bipolar disorder.Patients were divided into early-onset,intermediate-onset and late-onset groups according to their age of onset.The differences in characteristics and medications were compared among the three groups.Results:A total of 8184 patients with bipolar disorder were included,of which 1575(19.24%)were early-onset,5383(65.77%)were intermediate,and 1226(14.98%)were late-onset.The early-onset group had a younger age,a higher proportion of males and unmarried,a longer duration of illness and hospitalization,and a higher proportion of mixed states(P<0.05).A higher proportion of patients in the early-onset group used two mood stabilizers in combination with an antipsychotic,and the drug combination was dominated by lithium+valproate+quetiapine/olanzapine(P<0.05).A higher proportion of patients in the late-onset group used a mood stabilizer in combination with an antipsychotic,and the drug combination was dominated by valproate+quetiapine/ozapine(P<0.05).A higher proportion of patients in the late-onset group used a combination of antidepressants(P<0.05).Conclusion:There are significant differences in the demographic characteristics,clinical features and medication use of patients with bipolar disorder at different age of onset,and the age of onset of bipolar disorder should be taken seriously.