【摘要】：目的:建立精神科藥物的中毒篩查平臺(tái),輔助臨床精神科藥物中毒病患的診斷與急救。方法:依托液相色譜串聯(lián)質(zhì)譜(LC-MS/MS)儀,建立目前常用精神科藥物的檢測(cè)方法;采集疑似精神科藥物過(guò)量或中毒病患的胃液、尿液或血液,處理后采用LC-MS/MS進(jìn)行快速篩查和定量,獲得藥物濃度,及時(shí)進(jìn)行藥物劑量調(diào)整及中毒搶救,并進(jìn)行復(fù)查。結(jié)果:本中毒篩查平臺(tái)共收到院內(nèi)外急診病例1 183例。藥物過(guò)量或中毒病例中前四位氯氮平占34.09%,鎮(zhèn)靜催眠藥占29.54%,喹硫平占15.91%,氨磺必利占11.36%。兒童藥物中毒半數(shù)由藥物誤服引起,誤服的藥物排名前三位為:五氟利多、氟哌啶醇和氯氮平。以上患者經(jīng)劑量調(diào)整或搶救結(jié)束后再次復(fù)查,血中藥物降至安全范圍或完全消除。結(jié)論:本平臺(tái)的建立可以快速獲取患者中毒藥物信息,提高臨床醫(yī)生確診率,減少患者在中毒劑量的暴露時(shí)間,縮短轉(zhuǎn)歸時(shí)間。
[Abstract]:Objective: to establish a screening platform for the poisoning of psychotropic drugs and to assist in the diagnosis and first aid of patients with psychotropic drug poisoning. Methods: based on liquid chromatography-tandem mass spectrometry (LC-MS/MS), a method for the detection of commonly used psychotropic drugs was established. Gastric juice, urine or blood were collected from patients suspected of excessive or poisoning of psychotropic drugs. LC-MS/MS was used for rapid screening and quantification, drug concentration was obtained, drug dose adjustment and poisoning rescue were carried out in time, and re-examination was carried out. Results: the poisoning screening platform received 1 183 emergency cases in and out of hospital. The top four cases were clozapine (34.09), sedative hypnotic (29.54), quintiapine (15.91%) and ammosulapride (11.3636). Half of the drug poisoning in children was caused by drug misadministration. The top three drugs were pentaflurido, haloperidol and clozapine. After dose adjustment or reexamination, the blood drug was reduced to safe range or completely eliminated. Conclusion: the establishment of the platform can obtain the poisoning drug information quickly, improve the diagnosis rate of the clinicians, reduce the exposure time of the patients in the poisoning dose, and shorten the time of prognosis.
【作者單位】： 廣州醫(yī)科大學(xué)附屬腦科醫(yī)院/廣州市惠愛(ài)醫(yī)院藥學(xué)部;
【基金】：國(guó)家自然科學(xué)基金青年基金項(xiàng)目(編號(hào):81403016) 廣東省自然科學(xué)基金項(xiàng)目(編號(hào):2015A030313808) 廣州市醫(yī)藥衛(wèi)生科技項(xiàng)目(編號(hào):20151A011039)
【分類號(hào)】：O657.63;R595.4
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本文編號(hào)：2327915