| 孙倩,姜玮,罗炯,王雯,王虎,任艳萍.青少年双相情感障碍患者的临床特征及治疗现状[J].四川精神卫生杂志,2023,36(3):197-201.Sun Qian,Jiang Wei,Luo Jiong,Wang Wen,Wang Hu,Ren Yanping,Clinical features and treatment status of adolescent patients with bipolar disorder[J].SICHUAN MENTAL HEALTH,2023,36(3):197-201 |
| 青少年双相情感障碍患者的临床特征及治疗现状 |
| Clinical features and treatment status of adolescent patients with bipolar disorder |
| 投稿时间：2023-02-28 |
| DOI：10.11886/scjsws20230228001 |
| 中文关键词: 青少年 双相情感障碍 临床特征 药物治疗 |
| 英文关键词:Adolescent Bipolar disorder Clinical feature Medication therapy |
| 基金项目:科技部国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项（项目名称：精神心理疾病临床队列共享平台建设，项目编号：2017YFC1311101） |
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| 中文摘要: |
| 背景 双相情感障碍患者临床表现的性别和年龄差异会影响临床诊疗过程。目前，青少年双相情感障碍治疗效果不理想，已成为学习阶段致残的主要原因。目的 分析青少年双相情感障碍患者的临床特征及药物治疗现状，为个性化诊疗提供参考。方法 于2023年1月16日回顾性纳入2014年1月1日-2017年12月31日在首都医科大学附属北京安定医院住院的双相情感障碍患者1 169例，收集并分析病历资料，分别比较不同性别、不同年龄段的患者临床特征的差异，比较不同发作类型中不同性别的患者用药情况的差异。结果 男生躁狂发作的比例高于女生，女生抑郁发作的比例高于男生（P均<0.05）。女生伴非自杀性自伤行为的比例高于男生（χ2=7.761，P<0.01）。低龄组混合发作、伴冲动行为、有精神疾病家族史的比例高于高龄组，高龄组躁狂发作的比例高于低龄组（P<0.05或0.01）；高龄组住院时间长于低龄组（t=-2.930，P<0.01）。在躁狂发作患者中，男生服用丙戊酸盐和非典型抗精神病药的比例均高于女生（P均<0.01），在非典型抗精神病药中，男生服用利培酮和奥氮平（χ2=26.957）的比例均高于女生（P<0.05或0.01），女生服用喹硫平（χ2=14.865）和阿立哌唑的比例均高于男生（P均<0.01）。在抑郁发作患者中，男生服用奥氮平的比例高于女生（P<0.01）。在混合发作患者中，女生服用碳酸锂的比例高于男生（χ2=9.253，P<0.01），男生服用丙戊酸盐的比例高于女生（P<0.05）。结论 不同性别和年龄段的青少年双相情感障碍患者在诊断分类和伴随症状方面存在差异；在不同发作类型的青少年双相情感障碍患者中，不同性别的患者在碳酸锂、丙戊酸盐、非典型抗精神病药等用药情况上存在差异。 |
| 英文摘要: |
| Background Gender and age differences in the clinical manifestations of patients with bipolar disorder can affect the clinical diagnosis and treatment process. The current treatment effect of bipolar disorder in adolescents is not ideal， which has become the main reason for disability during the learning period.Objective To analyze the clinical features and medication therapy status of bipolar disorder in adolescents， and to provide references to support for personalized diagnosis and treatment.Methods On January 16， 2023， 1 169 patients with bipolar disorder who were hospitalized at Beijing Anding Hospital Affiliated Capital Medical University from January 1， 2014 to December 31， 2017 were retrospectively enrolled. Medical records were collected and analyzed to compare the clinical features among patients of different gender and age groups， and to explore the differences in medication use among patients of different genders in different types of seizures.Results Male patients reported a larger proportion of manic episodes， and a smaller proportion of depressive episodes than female patients （P<0.05）.Female patients reported a larger proportion of non-suicidal self-harm behaviors than male patients （χ2=7.761， P<0.01）.And patients in low-age group featured a larger proportion of mixed seizures， impulsive behaviors and family history of bipolar disorders along with a smaller proportion of manic episodes than those in high-age group （P<0.05 or 0.01）. High-age group had a longer average length of hospital stay than low-age group （t=-2.930， P<0.01）. In manic episode patients， males were found to have a larger proportion of valproate and atypical antipsychotic drug administration than females （P<0.01）. Among atypical antipsychotic drugs， males accounted for a larger proportion of administration of risperidone and olanzapine （χ2=26.957） than females （P<0.05 or 0.01）， while females constituted a larger proportion of administration of quetiapine （χ2=14.865） and aripiprazole than males （P<0.01）. In depressive episode patients， females had a larger proportion of administration of olanzapine than males （P<0.01）. In patients with mixed seizures， females occupied a larger proportion of administration of lithium carbonate than males （χ2=9.253， P<0.01）， and males exhibited a larger proportion of administration of valproate than females （P<0.05）.Conclusion Differences have been shown in diagnostic classification and concomitant symptoms among adolescent bipolar disorder of different genders and ages. Furthermore， medications of lithium carbonate， valproate， atypical antipsychotic and other drugs differ by gender among adolescents of different subtypes of bipolar disorder. ［Funded by Key Special Project of the National Key R&D Program of the Ministry of Science and Technology for "Major Chronic Non communicable Disease Prevention and Control Research" （number， 2017YFC1311101）］ |
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