门诊患者长期使用苯二氮[艹卓]类受体激动剂的药物依赖性分析  

Assessing the risk ofdrug dependence in outpatients chronically using benzodiazepine receptor agonists

作　　者：刘世昌 黄俊婷 邵刚 贾靖[1] 曲文峰 刘尚真 杨玉涛[1] 荣右明 LIU Shi-chang;HUANG Jun-ting;SHAO Gang;JIA Jing;QU Wen-feng;LIU Shang-zhen;YANG Yu-tao;RONG You-ming(Weifang Mental Health Center,Weifang 261072,Shandong,China;Shouguang General Hospital,Weifang 262700,Shandong,China;Shandong Adverse Reaction Center,Jinan 250013,China)

机构地区：[1]潍坊市精神卫生中心,山东潍坊261072 [2]寿光综合医院,山东潍坊262700 [3]山东省不良反应中心,济南250013

出　　处：《中国药物依赖性杂志》2024年第6期519-525,共7页Chinese Journal of Drug Dependence

基　　金：山东省药物滥用监测中心项目(2023SDADRKY25)。

摘　　要：目的以某精神专科医院门诊长期使用(≥6个月)苯二氮[艹卓]类受体激动剂(benzodiazepine receptor agonists,BzRAs)的患者为研究对象,分析不同用药模式药物依赖发生率及其影响因素,为临床医师、药师合理用药提供借鉴。方法以2022年1月至2023年6月门诊长期使用BzRAs的3435名患者为调查对象,分单用B、单用Z、联用B、联用B和Z四种用药模式,各完成110例药物依赖调查问卷,比较其药物依赖发生率,并以是否依赖为结局变量,分析探讨使用BzRAs产生依赖的危险因素。结果长期使用BzRAs的药物依赖发生率为45.48%。单Z、单B、联B和Z、联B四种用药模式药物依赖发生率依次递增,分别为27.88%、42.00%、54.90%、63.09%。多因素Logistic回归模型分析显示,得到用药时间超过2年、年龄超过40岁、日均地西泮当量超过20 mg等三个变量与依赖性有独立相关性。结论精神专科医院门诊患者联用BzRAs应注意药物依赖性的发生,中老年人、用药时长超过2年以及高剂量使用BzRAs会显著增加药物依赖风险。Objective This study aimed to analyze the dependence rate of different medication modes of benzodiazepine receptor agonists(BzRAs)among patients who have used them for long-term(≥6 months)in the outpatient department of a psychiatric hospital,and to identify its influencing factors.The findings aim to provide references for clinicians and pharmacists to rationally prescribe and use these drugs.Methods From January 2022 to June 2023,3435 outpatients who had been prescribed BzRAs for a prolonged period were selected as the study population.A dependence questionnaire was administered to 110 cases,categorized into four groups:single BzRA use,single Z-drug use,combined BzRA use,and combined BzRA and Z-drug use.The dependence rate was compared across these groups,and the outcome variable was defined as the presence or absence of dependence.Multivariate Logistic regression analysis was conducted to explore risk factors for BzRA dependence.Results The overall dependence rate for long-term BzRA use was 45.48%.Specifically,the dependence rates for single Z-drug use,single BzRA use,combined BzRA use,and combined BzRA and Z-drug use were 27.88%,42.00%,54.90%,and 63.09%,respectively.The multivariate Logistic regression model revealed that three variables were independently associated with BzRA dependence:medication duration exceeding 2 years,age over 40 years,and a daily diazepam equivalent dose exceeding 20 mg.Conclusion Special attention should be given to the occurrence of dependence among outpatients in psychiatric hospitals who use BzRAs in combination.Middle-aged and elderly individuals,medication durations exceeding 2 years,and high doses of BzRAs significantly increase the risk of dependence.

关 键 词：苯二氮[艹卓]类受体激动剂 药物依赖 BZDs Z类药物 长期使用 

分 类 号：R971.3[医药卫生—药品]