双相情感障碍224例用药分析  

Application of drugs in treatment of 224 bipolar disorder patients

作　　者：黄永兰[1] 章华[1] 陈振华[1] 杨灿[1] 朱志先[1] 

机构地区：[1]武汉大学人民医院精神卫生中心,湖北武汉430060

出　　处：《临床荟萃》2015年第8期935-937,共3页Clinical Focus

摘　　要：目的分析我院住院双相情感障碍(bipolar disorder BPD)患者药物应用现状,为临床合理用药提供参考。方法选择住院的224例BPD患者,分析双相躁狂及双相抑郁的心境稳定剂、非典型抗精神病药、抗抑郁药物使用比例及剂量。结果心境稳定剂应用比例为68.3%,非典型抗精神病药应用比例为77.3%。在双相躁狂(102例)及双相抑郁(122例)中,丙戊酸盐、奥氮平使用比例分别为(80.4%vs 45.1%;68.6%vs 18.0%),差异有统计学意义(P<0.05)。双相躁狂与双相抑郁中丙戊酸盐、奥氮平、喹硫平的剂量分别为(0.82±0.31)g vs(0.56±0.22)g;(13.39±6.14)mg vs(7.75±4.26)mg;(380.77±278.79)mg vs(163.89±191.25)mg,差异均有统计学意义(P<0.05)。双相抑郁中抗抑郁药使用频率71.3%,使用频率依次为舍曲林、艾司西肽普兰、米氮平、文拉法辛。结论丙戊酸盐及非典型抗精神病药(奥氮平和喹硫平)已经作心境稳定剂广泛应用于临床,且双相躁狂用药比例及剂量明显大于双相抑郁。双相抑郁治疗大多临床医生选择了在心境稳定剂的基础上合并抗抑郁药。Objective To analyze the drug application status of bipolar disorder （BPD） in patients of the hospital for reference in clinical rational drug use. Methods Ratio and doses of mood stabilizers and atypical antipsychotics were analyzed in bipolar mania （102 cases） and bipolar depression （n = 122） by SPSS 19.0. Antidepressants were analyzed in bipolar depression. Results Mood stabilizer application proportion was 68.3%, compared with 77.3 % for atypical antipsychotic drugs application. In bipolar mania （102 cases） and bipolar depression （122 cases）, valproic acid salt ratio was respectively 80.4% vs 45.1%, and olanzapine ratio was 80.4% vs 45.1 %, there were significantly difference （ P 〈0.05）. The doses of valproic acid salt, olanzapine and quetiapine in bipolar mania and bipolar depression were respectively （0.82 ±0.31 ） g vs （0.56 ±0.22 ） g; （13.39 ± 6.14） mg vs （ 7.75 ±4.26） mg;（380.77±278.79） mg vs （163.89±191.25） mg（P 〈0.05）. Antidepressant use ratio was 71.3%. The sequence was sertraline, escitalopram, mirtazapine, venlafaxine. Conclusion Valproic acid salt and atypical antipsychotics （olanzapine and quetiapine） were widely used to mood stabilizer in clinic, and the dosage of bipolar mania was bigger than that of bipolar depression. The physicians adopted therapeutic schedule of antidepressant with mood stabilizer or atypical antipsyehotic agents for bipolar depression.

关 键 词：情绪障碍 双相情感障碍 抗精神病药 

分 类 号：R749.4[医药卫生—神经病学与精神病学]