碳酸锂与丙戊酸在三级精神病专科医院治疗药物监测现状调查与分析  

Survey and analysis for therapeutic drug monitoring of lithium and valproate in first-class psychiatric hospitals in China

作　　者：果伟[1] 郭桂欣[1] 孙川[1] 张军[1] 荣璋[1] 孔国强[1] 李文标[1] 

机构地区：[1]首都医科大学附属北京安定医院临床精神药理实验室,北京100088

出　　处：《中国新药杂志》2013年第11期1347-1352,共6页Chinese Journal of New Drugs

基　　金：首都医学发展科研基金(2009-3135);北京市卫生局青年基金(QN2010-5);北京安定医院院级课题(2010)

摘　　要：目的:了解国内三级精神病专科医院锂盐和丙戊酸盐治疗药物监测现状,为进一步提高工作质量奠定基础。方法:自制调查问卷,内容包括实验室基本情况、治疗药物监测实施和质量控制3个方面。问卷回收后进行统计分析。结果:调查对象为三级精神病专科医院的TDM实验室。共发放问卷47份,收回来自24个省市、自治区、直辖市的问卷37份,回收率78.7%。经问卷有效性和真实性判断后,共26份问卷纳入统计。结论:70.3%的三级精神病专科医院已经开展锂盐和丙戊酸盐的治疗药物监测工作,其中以血清锂浓度监测最为普遍。70.8%开展锂盐检测的实验室采用离子选择性电极法,但不同分析方法的有效治疗浓度范围相差较大。两个项目的质控工作都有待进一步完善,特别是室间质评参与率不足20.0%。质控品缺失和日常样本量不足可能是目前制约质控工作的2个主要原因。Objective： To evaluate the practice patterns of therapeutic drug monitoring （TDM） of lithium and valproate in domestic first-class psychiatric hospitals, and analyze the status of TDM for mood stabilizers. Methods： The survey was an across-sectional study by online or paper-based questionnaires, including laboratory situation, TDM implementation and quality control. Then the collected data were statistically analyzed. Results： Forty-seven questionnaires were sent out to the chief persons who respond for TDM laboratories. Thirty-seven replies were collected from 24 provinces and municipalities, and the recovery rate was 78.7%. After the judgment of validity and authenticity, a total of 26 questionnaires were included in the statistics pool. Conclusion： This nationwide survey revealed that 70.3% of the first-class psychiatric hospitals in China have carried out TDM of lithium and valproate. For the detection of lithium, 70.8% institutions have used ion-selective electrode, and a difference has been found between effective therapeutic concentration ranges of different analytical methods. Internal quality control and external quality assessment of the two mood stabilizers are inadequate; no more than 20.0% laboratories have participated in an EQA program. The main perceived reasons are lack of quality control materials and insufficient daily samples.

关 键 词：治疗药物监测 情感稳定剂 碳酸锂 丙戊酸 调查 

分 类 号：R971.41[医药卫生—药品]