743例精神分裂症住院患者用药情况及不良反应分析

Analysis of drug use and adverse reactions in 743 hospitalized patients with schizophrenia

目的对743例精神分裂症住院患者用药情况及不良反应进行分析,指导临床用药。方法选择我院明确诊断为精神分裂症的住院患者作为样本,对743例患者单日用药情况进行分析,记录抗精神病药物及辅助药物(β受体阻滞剂、苯二氮[艹卓]类、非苯二氮[艹卓]类镇静催眠药物、抗抑郁药物、抗焦虑药、抗癫痫药、心境稳定剂等)的使用情况及药物不良反应。结果抗精神病药物总体使用情况显示氯氮平311例(31.01%)、利培酮216例(21.54%)、奥氮平136例(13.56%)、喹硫平121例(12.06%)、阿立哌唑93例(9.27%);抗精神病药单一用药治疗484例(65.14%),联用2种抗精神病药258例(34.72%),联用3种药物1例(0.13%);辅助用药中,使用β受体阻滞剂342例,占比为46.03%;苯二氮[艹卓]类21例、非苯二氮[艹卓]类镇静催眠药物5例,占比分别为2.82%、0.67%;抗抑郁药物62例、抗焦虑药6例、心境稳定剂307例、抗癫痫药13例,占比分别为8.34%、0.81%、41.32%、1.75%。药物不良反应发生率前五位的是椎体外系反应328例(44.20%)、血脂升高284例(38.27%)、肝功能损害(转氨酶升高)88例(11.86%)、白细胞下降39例(5.26%)、尿酸升高35例(4.71%)。结论精神分裂症住院患者的抗精神病治疗,以单一用药方案为主,并大多使用第二代(非典型)抗精神病药,用药方案基本合理;辅助用药治疗中,β受体阻滞剂、心境稳定剂的使用率较高;药物不良反应发生率相对较高。

Objective To analyze the medication situation and adverse reactions of 743 hospitalized patients with schizophrenia,and guide clinical medication.Methods We selected hospitalized patients with a clear diagnosis of schizophrenia in our hospital as samples,analyzed the daily medication use of 743 patients,and recorded antipsychotic and adjuvant drugs(beta blockers,benzodiazepines,non benzodiazepine sedative and hypnotic drugs,antidepressants,anxiolytics,antiepileptics,mood stabilizers),etc.Results The overall use of antipsychotic drugs showed 311 cases of clozapine(31.01%),216 cases of risperidone(21.54%),136 cases of olanzapine(13.56%),121 cases of quetiapine(12.06%),and 93 cases of aripiprazole(9.27%).484 cases(65.14%)were treated with antipsychotic drugs alone,258 cases(34.72%)were treated with two antipsychotic drugs in combination,and 1 case(0.13%)was treated with three antipsychotic drugs in combination.In auxiliary medication,342 cases of beta blockers,accounting for 46.03%.21 cases of benzodiazepines and 5 cases of non benzodiazepine sedative and hypnotic drugs,accounting for 2.82%and 0.67%respectively.There were 62 cases of antidepressants,6 cases of anxiolytics,307 cases of mood stabilizers,and 13 cases of antiepileptic drugs,accounting for 8.34%,0.81%,41.32%,and 1.75%,respectively.The top five incidence rates of adverse drug reactions were 328 cases(44.20%)of extrapyramidal system reaction,284 cases(38.27%)of hyperlipemia,88 cases(11.86%)of liver dysfunction(elevated transaminases),39 cases(5.26%)of leukopenia,and 35 cases(4.71%)of hyperuricemia.Conclusion The antipsychotic treatment for hospitalized patients with schizophrenia is mainly based on a single medication regimen,and most of them use second-generation(atypical)antipsychotic drugs,with a basically reasonable medication regimen;In adjuvant therapy,beta blockers and mood stabilizers is relatively high.The incidence of adverse drug reactions is relatively high.