基于液相色谱-二级质谱联用技术精神科药物中毒筛查平台的构建与临床应用

发布时间：2018-11-12 18:51

【摘要】：目的:建立精神科药物的中毒筛查平台,辅助临床精神科药物中毒病患的诊断与急救。方法:依托液相色谱串联质谱(LC-MS/MS)仪,建立目前常用精神科药物的检测方法;采集疑似精神科药物过量或中毒病患的胃液、尿液或血液,处理后采用LC-MS/MS进行快速筛查和定量,获得药物浓度,及时进行药物剂量调整及中毒抢救,并进行复查。结果:本中毒筛查平台共收到院内外急诊病例1 183例。药物过量或中毒病例中前四位氯氮平占34.09%,镇静催眠药占29.54%,喹硫平占15.91%,氨磺必利占11.36%。儿童药物中毒半数由药物误服引起,误服的药物排名前三位为:五氟利多、氟哌啶醇和氯氮平。以上患者经剂量调整或抢救结束后再次复查,血中药物降至安全范围或完全消除。结论:本平台的建立可以快速获取患者中毒药物信息,提高临床医生确诊率,减少患者在中毒剂量的暴露时间,缩短转归时间。
[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.
【作者单位】： 广州医科大学附属脑科医院/广州市惠爱医院药学部;
【基金】：国家自然科学基金青年基金项目(编号:81403016) 广东省自然科学基金项目(编号:2015A030313808) 广州市医药卫生科技项目(编号:20151A011039)
【分类号】：O657.63;R595.4
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本文编号：2327915