抗抑郁药物在综合性医院门诊中的应用情况及人群特点分析
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摘要
目的分析抗抑郁药物在综合性医院门诊中的应用情况及人群特点。方法选择吉林大学第一医院2014年6月至2017年6月使用抗抑郁药物门诊处方共80 505张,其中抗抑郁药物用药医嘱87 514条,就诊患者45 066例,按患者性别、年龄、临床诊断、就诊科室以及应用的抗抑郁药物名称等项目进行分类统计,分析不同年龄段抗抑郁药物使用人群的性别比例、抗抑郁药物在不同年龄段的用药医嘱分布情况以及抗抑郁药物用药医嘱分布较多的临床诊断、临床科室。结果 45 066例使用抗抑郁药物的患者男女比例基本相当[51. 72%(23 308例)比48. 28%(21 758例)],但不同年龄段性别比例不同,≤19岁患者中男性占71.05%(1 836/2 584)、女性占28.95%(748/2 584),20～29岁男性占57.38%(4 115/7 171),40～49岁男女比例基本相当,50～59、60～69、70～79岁女性比例增加,而> 79岁的老年患者中男性比例又再次升高达61. 09%(482/789)。各年龄段中以40～49岁就诊例数最多。抗抑郁药物用药医嘱数量居前3位者分别为盐酸舍曲林片(15 781条)、氢溴酸西酞普兰片(15 240条)和草酸艾司西酞普兰片(13 529条),均为选择性5-羟色胺再摄取抑制剂。临床诊断为精神障碍、睡眠障碍、焦虑症者抗抑郁药物用药医嘱数最多,占66.97%(58 605/87 514);79. 44%(69 525/87 514)的抗抑郁药物在心理卫生科使用,占比较高的还有神经内科6 966条(7. 96%)、男科3 512条(4. 01%)、心血管内科1 319条(1. 51%)、干部病房1 253条(1.43%)。结论选择性5-羟色胺再摄取抑制剂等新型抗抑郁药物已成为临床治疗抑郁症的首选药,符合我国目前抗抑郁药物的发展趋势。
Objective To investigate the use of antidepressant drugs in outpatients and to analyze the characteristics of medication population. Methods From June 2014 to June 2017, 80 505 prescriptions of antidepressants were retrieved from the outpatient department of the First Hospital of Jilin University; 45 066 patients with 87 514 medical records were reviewed. The prescriptions were classified and counted according to sex, age,clinical diagnosis, visiting department and type of antidepressants; characteristics of drug application were analyzed.Results Proportions of male and female in 45 066 patients using antidepressants were similar[51.72%(23 308/45 066) vs48. 28%(21 758/45 066) ]. Sex composition showed differences among patients in different age groups; males accounted for 71. 05%( 1 836/2 584) and females accounted for 28. 95%(748/2 584) in patients≤19 years old;in 20-29 years old group, males accounted for 57. 38%(4 115/7 171); proportions of male and female were similar in 40-49 years old group; the proportion of female increased with age in 50-59, 60-69 and 70-79 years old patients; the proportion of male in patients over 79 years old was 61. 09%(482/789). Overall, patients between40 and 59 years old took up the largest proportion. The top three commonly used antidepressants were sertraline hydrochloride tablets(15 781 records), citalopram hydrobromide tablets(15 240 records) and escitalopram oxalate tablets(13 529 records), which were all selective serotonin reuptake inhibitors. The top three diseases were mental disorder, sleep disorder and anxiety, which accounted for 66. 97%(58 605/87 514). Antidepressants were mostly used in department of mental health, accounting for 79.44%(69 525/87 514), followed by departments of neurology [ 6 966( 7.96%)], male disease[3 512(4.01%)], cardiovascular medicine[1 319(1.51%)] and cadre ward[ 1 253(1.43%) ]. Conclusion Selective serotonin reuptake inhibitors have become the first choice of antidepressants.
Objective To investigate the use of antidepressant drugs in outpatients and to analyze the characteristics of medication population. Methods From June 2014 to June 2017, 80 505 prescriptions of antidepressants were retrieved from the outpatient department of the First Hospital of Jilin University; 45 066 patients with 87 514 medical records were reviewed. The prescriptions were classified and counted according to sex, age,clinical diagnosis, visiting department and type of antidepressants; characteristics of drug application were analyzed.Results Proportions of male and female in 45 066 patients using antidepressants were similar[51.72%(23 308/45 066) vs48. 28%(21 758/45 066) ]. Sex composition showed differences among patients in different age groups; males accounted for 71. 05%( 1 836/2 584) and females accounted for 28. 95%(748/2 584) in patients≤19 years old;in 20-29 years old group, males accounted for 57. 38%(4 115/7 171); proportions of male and female were similar in 40-49 years old group; the proportion of female increased with age in 50-59, 60-69 and 70-79 years old patients; the proportion of male in patients over 79 years old was 61. 09%(482/789). Overall, patients between40 and 59 years old took up the largest proportion. The top three commonly used antidepressants were sertraline hydrochloride tablets(15 781 records), citalopram hydrobromide tablets(15 240 records) and escitalopram oxalate tablets(13 529 records), which were all selective serotonin reuptake inhibitors. The top three diseases were mental disorder, sleep disorder and anxiety, which accounted for 66. 97%(58 605/87 514). Antidepressants were mostly used in department of mental health, accounting for 79.44%(69 525/87 514), followed by departments of neurology [ 6 966( 7.96%)], male disease[3 512(4.01%)], cardiovascular medicine[1 319(1.51%)] and cadre ward[ 1 253(1.43%) ]. Conclusion Selective serotonin reuptake inhibitors have become the first choice of antidepressants.
引文
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[3]苑杰,高静,肖健,等.抗抑郁药物的联合用药研究进展[J].中国医药导报,2017,14(27):40-43.Yuan J, Gao J, Xiao J, et al. Research progress of combination drugs of antidepressants[J]. China Medical Herald, 2017,14(27):40-43.
[4]陆霞娟,卞鑫.兰索拉唑结合氟哌噻吨美利曲辛片治疗非糜烂性胃食管反流病临床观察[J].中国医师杂志,2014,16(4):531-532. DOI:10.3760/cma. j. issn. 1008-1372.2014.04.034.Lu XJ, Bian X. Clinical observation of lansoprazole combined with Flupentixol and Melitracen Tablets in the treatment of non erosive gastroesophageal reflux disease[J]. Journal of Chinese Physician,2014,16(4):531-532. DOI:10. 3760/cma. j. issn. 1008-1372.2014.04.034.
[5]危林松.高血压并发焦虑抑郁症状260例患者心理干预治疗分析[J].中国临床实用医学,2010,4(10):205-206. DOI:10.3760/cma. j. issn1673-8799.2010. 10.135.Wei LS. Analysis of psychological intervention for 260 patients with hypertension complicated with anxiety and depression[J]. China Clinical Practical Medicine, 2010,4(10):205-206. DOI:10.3760/cma. j. issnl673-8799.2010. 10.135.
[6]杨京帆.呼吸内科老年患者抑郁障碍及其治疗分析[J].医学理论与实践,2014,27(17):2292-2293.Yang JF. Depressive disorder and its treatment in geriatric patients in Department of respiratory medicine[J]. The Journal of Medical Theory and Practice, 2014,27(17):2292-2293.
[7]姜巧巧.2011-2013年北京市垂杨柳医院门诊抗抑郁药应用分析[J].中国医院用药评价与分析,2016,16(4):515-518. DOI:10. 14009/j. issn. 1672-2124.2016.04.032.Jiang QQ. Analysis on application of antidepressants in Beijing Chuiyangliu hospital during 2011-2013[J]. Evaluation and Analysis of Drug-Use in Hospitals of China, 2016,16(4):515-518. DOI:10.14009/j. issn. 1672-2124.2016.04.032.
[8]蒋小娟,赵利云,程灶火,等.儿童和青少年心理障碍与家庭教养方式的关联研究[J].中国临床心理学杂志,2013,21(5):800-803,806.Jiang XJ, Zhao LY, Cheng ZH, et al. Association between family parenting and mental disorders in child and adolescent[J].Chinese Journal of Clinical Psychology, 2013,21(5):800-803,806.
[9]杨碧秀,王志强,曹磊明,等.父母教养方式差异与儿童青少年心理健康的关系[J].临床精神医学杂志,2015,25(6):381-383.Yang BX, Wang ZQ, Cao LM, et al. The relationship between parental rearing differences and mental health of children and adolescents[J]. Journal of Clinical Psychiatry, 2015,25(6):381-383.
[10]李玉霞.青少年抑郁、焦虑情绪与其相关因素[J].中国健康心理学杂志,2013,21(3):415-417.Li YX. The Emotion of depression and anxiety of adolescents and their relative factors[J]. China Journal of Health Psychology,2013,21(3):415-417.
[11]王明忠,范翠英,周宗奎,等.父母冲突影响青少年抑郁和社交焦虑-基于认知-情境理论和情绪安全感理论[J].心理学报,2014,46(1):90-100. DOI:10.3724/SP. J. 1041.2014.00090.Wang MZ, Fan CY, Zhou ZK, et al. Parental conflict affects adolescents'depression and social anxiety:based on cognitivecontextual and emotional security theories[J]. Acta Psychologica Sinica, 2014, 46(1):90-100. DOI:10. 3724/SP. J. 1041.2014.00090.
[12]宫翠风,王惠萍,尉秀峰,等.童年期创伤性经历与青少年抑郁症的关系[J].中国健康心理学杂志,2016,24(7):1076-1079.D01:10. 13342/j.cnki.cjhp.2016.07.031.Gong CF, Wang HP, Wei XF, et al. The relationship between childhood traumatic experiences and adolescent depression[J].China Journal of Health Psychology, 2016,24(7):1076-1079.DOI:10. 13342/j.cnki.cjhp.2016.07.031.
[13]刘洋,张伟波,蔡军.青少年学生焦虑抑郁情绪特征与研究现状[J].中国医药导报,2016,13(12):53-56.Liu Y, Zhang WB, Cai J. The characteristics and research status of teenager depression and anxiety[J]. China Medical Herald, 2016,13(12):53-56.
[14]赵紫楠,邵宏,聂小燕,等.2010-2011年我国六城市抗抑郁药临床应用现状及分析[J].中国医院药学杂志,2013,33(23):1986-1988.Zhao ZN, Shao H, Nie XY, et al. Current situation and analysis of clinical application of antidepressants in six cities of China in.2010-2011[J]. Chinese Journal of Hospital Pharmacy, 2013,33(23):1986-1988.
[15]陈瑞玲,赵志刚,王雅杰,等.2010-2014年北京地区22家医院抗抑郁药物应用研究[J].中国药物应用与监测,2016,13(2):105-108.Chen RL, Zhao ZG, Wang YJ, et al. Application analysis on antidepressant drugs of 22 hospitals in Beijing from 2010 to2014[J]. Chinese Journal of Drug Application and Monitoring,2016,13(2):105-108.
[16] Bali V, Holmes HM, Johnson ML, et al. Comparative effectiveness of second-generation antidepressants in reducing the risk of dementia in elderly nursing home residents with depression[J]. Pharmacotherapy, 2016,36(1):38-48. DOI:10.1002/phar. 1680.
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