2019 年第 1 期 第 14 卷

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

Use of antidepressants and characteristics of medication population in outpatients

作者：宗哲刘鑫张四喜

英文作者：

单位：130021长春，吉林大学第一医院药学部

英文单位：

关键词：抗抑郁药物；门诊；5-羟色胺再摄取抑制剂

英文关键词：

• 摘要：

• 【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。

• 【Abstract】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) vs 48.28%(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 between 40 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%）］. Conclusions    elective serotonin reuptake inhibitors have become the first choice of antidepressants.