基于血药浓度测定的社区精神分裂症患者服药情况及影响因素分析  

The Analysis of Drug Use and Influencing Factors in Community Schizophrenia Patients Based on Blood Drug Concentration Determination

作　　者：林红 童皓 田玉玲 LIN Hong;TONG Hao;TIAN Yuling(Department of Psychiatry,Yichang Mental Health Center,Yichang 443005,China;Clinical Laboratory,Yichang Mental Health Center,Yichang 443005,China)

机构地区：[1]宜昌市精神卫生中心精神科,宜昌443005 [2]宜昌市精神卫生中心检验科,宜昌443005

出　　处：《福建医科大学学报》2023年第3期171-176,共6页Journal of Fujian Medical University

基　　金：宜昌市医疗卫生研究项目(A22-2-075)。

摘　　要：目的了解社区精神分裂症患者服药情况及其影响因素。方法对湖北省宜昌市5个不同地区的250例社区精神分裂症患者,采用高效液相色谱-串联质谱法测定其血药浓度,了解患者的服药达标情况,并分析婚姻状况、年龄、监护情况等对服药情况的影响。结果218例患者完成测试,规律服药212例,间断服药5例,未服药1例;血药浓度达标99例,未达标83例,未检出36例。不同年龄段、婚姻状况、经济状况、监护人类型及是否参加社区康复患者服药达标情况的差别均有统计学意义(P<0.05)。进一步行logistic回归分析显示,参加社区康复可显著提高服药达标率[OR=2.611(1.314~5.189)]。结论社区精神分裂症患者实际服药情况与系统报告的服药依从性存在差距,可采取鼓励患者参加社区康复的方式予以提升。Objective To analyze the medication situation and its influencing factors of patients with schizophrenia in the community.Methods For 250 community schizophrenia patients in 5 different districts of Yichang City,Hubei Province,the serum drug concentrations were measured by high performance liquid chromatography-tandem mass spectrometry to understand patient s medication compliance and analyze the influence of marital status,age,and guardianship.Results A total of 218 patients completed the test,212 patients reported regular medication,5 patients took intermittent medication,1 patient did not take medication.Ninety-nine patients reached the standard blood drug concentration,83 patients did not reach the standard,and 36 patients were not detected.There were statistically significant differences in the medication compliance among patients of different age groups,marital status,economic status,guardian type,and whether they participated in community rehabilitation(P<0.05).Further logistic regression analysis showed that only whether or not participating in community rehabilitation had a significant impact on medication compliance[OR=2.611(1.314-5.189)].Conclusion There is a discrepancy between the actual medication compliance of schizophrenia patients in the community and the medication compliance reported by the system,which can be improved by encouraging patients to participate in community rehabilitation.

关 键 词：精神分裂症 血药浓度监测 服药依从性 影响因素 社区康复 宜昌市 

分 类 号：R749.3[医药卫生—神经病学与精神病学]