帕罗西汀治疗抑郁症患者的血药浓度影响因素及参考范围研究

目的:本研究旨在探讨帕罗西汀在治疗药物监测中血药浓度的相关影响因素,并建立我院帕罗西汀血药浓度参考区间,为临床安全、合理地使用帕罗西汀提供参考。方法:收集我院2021年1月至2023年12月服用帕罗西汀治疗抑郁症达稳态血药浓度患者监测数据共272例统计学资料,考察性别、年龄、日剂量、民族、联合用药对帕罗西汀稳态谷浓度的影响,并建立帕罗西汀血药浓度参考区间,结合病例情况分析影响帕罗西汀稳态血药浓度的影响因素。结果:研究初步确定我院患者使用帕罗西汀治疗抑郁症时不同性别稳态血药浓度的参考区间。在相同日给药剂量下不同年龄、不同联合用药、不同民族患者帕罗西汀血药浓度的差异无统计学意义(P > 0.05)。但在30 mg/d和40 mg/d的剂量下,男性与女性的血药浓度存在显著差异(P Objective: The aim of this study is to explore the relevant influencing factors of paroxetine blood concentration in therapeutic drug monitoring, and to establish the reference interval of paroxetine blood concentration in our hospital, so as to provide reference for the safe and reasonable use of paroxetine in clinical practice. Methods: A total of 272 cases of statistical data were collected from January 2021 to December 2023 from our hospital to take paroxetine to treat depression up to steady-state blood concentration patients monitoring data, to investigate the influence of gender, age, daily dose, ethnicity, and combination of drugs on the steady-state trough concentration of paroxetine, and to establish the reference interval of paroxetine blood concentration, combined with the case situation to analyse the impact of the influence of the steady-state blood concentration of paroxetine factors. Results: The study preliminarily determined the reference intervals for steady state blood concentrations of different genders in the treatment of depression with paroxetine in our patients. The differences in paroxetine blood concentrations in patients of different ages, different combinations of medications, and different ethnicities at the same daily administered dose were not statistically significant (P > 0.05). However, there was a significant difference in blood concentrations between males and females at doses of 30 mg/d and 40 mg/d (P < 0.05). Conclusion: The reference intervals of steady state blood concentration of paroxetine in the treatment of depression in our hospital were 28.91~104.0 ng/mL in men and 33.46~124.39 ng/mL in women. Gender is an important factor affecting the steady state blood concentration of paroxetine, and the mean steady state blood concentration of women was higher than that of men under the condition of the same dosage of the drug administered, which may be related to gender Physiological differences in drug metabolism, such as body fat content, hormone levels and other factors affecting the distribution and clearance of the drug.

PBL教学模式在精神病学教学中的应用研究

目的研究PBL教学模式在精神病学教学中的应用价值。方法调查筛选2023年4—6月临床本科专业学生162人,随机分成PBL组(观察组)和传统教学组(对照组),每组81人。时间3个月,间隔1个月测试1次,进行3次同一试卷测试,对比两组差异。结果观察组临床本科专业学生疾病核心知识得分、鉴别诊断能力、与患者交流能力、人文关怀能力显著高于对照组,差异有统计学意义(P<0.05)。观察组见习单位满意度评价完全满意率显著高于对照组,差异有统计学意义(P=0.000<0.05)。结论PBL教学法在精神病学教学领域的实际运用中,已展现出了增强学生专业能力与提升见习满意度的显著成效。鉴于此,强烈建议将此教学法作为重要手段,在临床本科专业学生中广泛推广并深入实施。

慢性心力衰竭患者及主要照顾者的照护能力现状及影响因素

目的:评价慢性心力衰竭患者的自护能力及主要照顾者自护贡献能力,并分析其各自影响因素。方法:以某医院61对住院慢性心力衰竭患者及其主要照顾者为研究对象,通过访谈和问卷调查收集资料。结果:慢性心力衰竭患者自护能力得分为(43.5±10.7)分,主要照顾者自护贡献能力得分为(42.9±10.2)分,二者呈显著正相关。慢性心力衰竭患者的心衰知识水平、住院次数、文化程度、民族是其自护能力的主要影响因素;主要照顾者的心衰知识水平、每天照顾时间、自觉健康状况和患者的住院次数是自护贡献能力的主要影响因素。结论:慢性心力衰竭患者及主要照顾者的自护能力/自护贡献能力普遍低下,其影响因素涉及人口学及临床特征。

地震后心理危机干预研究现状

当个体经历地震、火灾、新型冠状病毒(COVID-19)感染的肺炎疫情、家庭变故等危机事件而无法自行应对时,非常容易导致心理危机,此时需要专业人员进行系统、科学的心理危机干预。本文围绕地震后心理危机干预的理论、模型以及目前国内外研究现状,作一综述。