Lack of a pharmacokinetic drug-drug interaction between lithium and valproate when co-administered with aripiprazole

What is known and Objective: The antipsychotic, aripiprazole, plus lithium or valproate demonstrates rapid and significant improvement in manic symptoms that is sustained over the long term. A previous report showed that therapeutic doses of either lithium or valproate had no clinically significant effects on the pharmacokinetics of aripiprazole. We aimed to determine the effects of co‐administration of aripiprazole on the steady‐state pharmacokinetics of lithium or valproate in healthy subjects. Materials and Methods: Two similarly designed, open‐label, single‐sequence studies were conducted. Healthy subjects received daily oral doses of either lithium (450 mg every 12 h) or valproate (500 mg every 12 h) on Days 1–7. Following Day 7 was a 2‐day washout period, and on Day 10, subjects began receiving oral doses of aripiprazole (10 mg once daily) for 2 days. Aripiprazole was then titrated from 10 to 20 mg once daily to establish tolerance of aripiprazole. On Day 14, the dose was escalated and subjects received aripiprazole 30 mg once daily for 13 days. Beginning on Day 20, subjects received lithium (450 mg every 12 h) or valproate (500 mg every 12 h) concomitantly with aripiprazole 30 mg once daily through Day 26. Serial blood samples for serum lithium or valproate concentration determination were collected for up to 12 h post‐lithium or valproate administration on Days 7 and 26. Results: The lithium study enrolled 32 healthy subjects (72% completed the study), and the valproate study enrolled 48 healthy subjects (58% completed the study). In both studies, the 90% confidence intervals for the ratios of population geometric means, with and without aripiprazole, were contained within 80% and 125% for both the C_max and AUC_τ, respectively. Furthermore, the addition of aripiprazole did not change the median T_max of lithium or valproate (4 h). Thus, the addition of aripiprazole did not affect the steady‐state pharmacokinetics of lithium or valproate. The majority of subjects (76·9% for aripiprazole plus lithium and 68·4% for aripiprazole plus valproate) reported adverse events, but this adverse event profile is consistent with what has been observed in other studies. What is new and Conclusion: The addition of aripiprazole to either lithium or valproate had no clinically meaningful effects on the pharmacokinetics of either drug. In addition, co‐administration of aripiprazole with lithium or valproate demonstrated no unexpected safety signals in healthy subjects.     

奎硫平联合碳酸锂治疗双相躁狂对照研究

目的探讨奎硫平联合碳酸锂治疗双相躁狂的临床疗效及安全性。方法将70例双相障碍躁狂发作患者随机分为两组各35例,研究组给予奎硫平联合碳酸锂治疗,对照组给予氯丙嗪联合碳酸锂治疗;观察6w。于治疗前及治疗2w、6w末应用Beck-Rafaelsen躁狂量表及副反应量表评定临床疗效和不良反应。结果治疗6w末,研究组显效率88.2%、有效率97.1%;对照组分别为84.8%、96.9%。两组比较均无显著性差异（P〉0.05）。Beck-Rafaelsen躁狂量表评分,治疗2w末起两组均较治疗前有显著性下降（P〈0.01）,并随着治疗时间的延续均呈持续性下降,但研究组治疗2w末较对照组下降显著（P〈0.05）,6w末无显著性差异（P〉0.05）;研究组不良反应总发生率显著低于对照组（χ^2=4.06,P〈0.05）。结论奎硫平联合碳酸锂治疗双相躁狂,疗效显著、起效快、安全性高、依从性好,值得临床推广应用。     

The preventive effect of lithium therapy on bipolar disorder patients,with special reference to gender and age

In prophylactic treatment of patients having bipolar disorders (BD), lithium, no doubt, plays an important role. The hypothesis of this register study was that said patients, thanks to lithium therapy, would spend fewer and shorter stays in the hospital. We used ipsative control techniques in a study of 60 patients during two periods of 20 months each, one before and the other after the lithium therapy began. We found significant statistical differences regarding the average number (p<.004) and length (p<.001) of stays in hospital comparing pre-lithium treatment to post-lithium treatment. These averages also revealed statistical differences with regard to age (number of stays,p<.002; length of stays,p<.047), with older patients obtaining greater benefit from treatment than younger patients. There were no such differences with regard to gender (number of stays,p<.602; length of stays,p<.584). That BD patients respond favorably to lithium treatment is a well-known finding. On the other hand, we know of no previous study indicating that older patients obtain better results with lithium therapy than do younger patients. Yet because this study occurred over a 20-year period, there are some grounds that probably would substantiate this comparative statement; namely, that one does comply more easily as one gets older, that diagnoses are currently more accurate than they were before, and that care routines have improved.     

拉莫三嗪与碳酸锂治疗双相障碍急性抑郁发作对照研究

目的评价拉莫三嗪治疗双相障碍急性抑郁发作的疗效及安全性。方法采用随机、平行对照的方法将117例双相障碍抑郁发作患者分别以拉莫三嗪（n=59）和碳酸锂治疗（n=58）,疗程8周,分别于治疗前和治疗后第1周、2周、4周、6周、8周末以汉密尔顿抑郁量表、Young躁狂评定量表及临床疗效总评量表评价疗效,副反应量表评定不良反应。结果拉莫三嗪治疗组有效率为67．8％（40／59）,碳酸锂组为72．4％（42／58）,两组疗效差异无显著性（P〉0．05）。拉莫三嗪组的药物不良反应发生率（23．7％）显著低于碳酸锂组（41．3％）（P〈0．05）。结论拉莫三嗪与碳酸锂治疗双相障碍急性抑郁发作均有效,但前者不良反应较少,安全性好。     

电导率对肾脏浓缩稀释功能检测的意义

目的评价UF-100尿沉渣分析仪检测电导率用于肾脏浓缩稀释功能检测的价值。方法140例标本配对用UF-100尿沉渣分析仪测定电导率和冰点渗透压计测定渗透压。两法也同时用于尿崩症患者的禁水-加压素试验。结果电导率和渗透压测定结果高度相关,r=0.8583,P<0.01,渗透压对电导率的直线回归方程为Y=33.913X-98.024。重复性实验电导率CV为2.6%,渗透压CV为3.4%。结论电导率可作为正确评价肾脏浓缩稀释功能的一个良好的替代参数。     

Relationship between GHb concentration and erythrocyte survival determined from breath carbon monoxide concentration

OBJECTIVE: Subjects with decreased erythrocyte survival have an unusually low GHb percentage. The goal of this study was to determine whether hyperglycemia, as reflected by GHb percentage, is associated with decreased erythrocyte survival. RESEARCH DESIGN AND METHODS: Erythrocyte survival was quantitated in 23 subjects with type 2 diabetes, and these values were correlated with the subjects' GHb percentage. Erythrocyte survival was determined from the difference between the subjects' alveolar carbon monoxide (CO) concentration and atmospheric CO concentration. Reticulocyte counts were obtained in 16 subjects. RESULTS: Although the vast majority of the subjects had erythrocyte life spans that fell within the normal range (123 +/- 23 days), there was a highly significant inverse correlation (r = -0.66, P < 0.01) between life span and GHb percentage, with an average decline in life span of 6.9 days for each 1% rise in GHb. The reticulocyte count inversely correlated with erythrocyte life span (r = -0.77, P < 0.01). CONCLUSIONS: Hyperglycemia, as evidenced by high GHb percentage, is associated with an appreciable decrease in erythrocyte life span. Because GHb appears to be formed over the lifetime of the erythrocyte, this decreased erythrocyte survival suggests that high GHb percentages may systematically underestimate the true degree of hyperglycemia.     

Relationship between serum osteoprotegerin,glycemic control,renal function and markers of atherosclerosis in type 2 diabetes

Abstract

We aimed to investigate the relationship between serum osteoprotegerin (OPG) level and glycemic control, lipids, renal function, microalbuminuria, insulin resistance and markers of atherosclerosis including C-reactive protein (CRP), fibrinogen and erythrocyte sedimentation rate (ESR) in patients with type 2 diabetes mellitus (DM). A total of 166 patients (99 women and 67 men) with type 2 DM were recruited in the study. Serum OPG level was higher in poorly controlled diabetic patients (HbA_1c ≥ 7%) than in well-controlled diabetic patients (HbA_1c < 7%) [4.0 (3.6–5.0) and 3.5 (2.9–4.4) pmol/L, p = 0.02]. There was no difference between the patients with and without microalbuminuria with respect to OPG levels (p > 0.05). LogOPG was correlated with age (r = 0.47, p = 0.0001). After adjustment for age, sex and BMI, logOPG correlated positively with fasting blood glucose (FBG) (r = 0.28, p = 0.001), prandial blood glucose (PBG) (r = 0.22, p = 0.009), glycated hemoglobin (HbA_1c) (r = 0.26, p = 0.002), logHOMA-IR (r = 0.30, p = 0.006), fibrinogen (r = 0.17, p = 0.04), mean albumin excretion rate (MAER) (r = 0.20, p = 0.01) and negatively with creatinine clearance (r = ? 0.20, p = 0.01). Regression analysis revealed that logOPG was independently associated with age (p = 0.0001), HbA_1c (p = 0.01) and MAER (p = 0.02) (r² = 0.25). In conclusion; we found that serum OPG levels are increased in poorly controlled type 2 DM and associated with age, glycemic control and microalbuminuria.     

The improvement of renal concentration capacity after surgery for primary hyperparathyroidism

BACKGROUND: Improvement of renal concentration capacity was long ago shown to occur after surgery for primary hyperparathyroidism (pHPT). Study of concentration capacity is of interest, as it was also shown to be a predictive factor for the risk of death in patients with pHPT, and it affected the risk of death independently of 33 other variables in multivariate analysis. METHODS: There were 98 patients with verified pHPT operated on in the years 1958-81, who had urine osmolality determinations performed both before and after surgery: 63 immediately after, and 35 with mean 3.9 years delay (SD = 1.8). Another seven patients with pHPT had urine osmolality determinations performed preoperatively only. Non-parametric sign tests, regression analysis, and correlation tests were performed. RESULTS: Both patients with severe or moderate, and mild pHPT showed a substantial change of renal concentration capacity, with mean increase of 28.3% (SD = 28.4). The increase generally occurred soon after surgery. In eight out of 98 patients, there was no improvement. A relationship was found between improvement and preoperative peak serum calcium level. In seven out of seven patients followed, untreated for mean 5.3 years (SD = 3.2), there was a mean 15% (SD = 8.0) deterioration of renal concentration capacity. CONCLUSIONS: The findings of this study add cause for surgery in patients with pHPT and give no reason for different treatment of severe, moderate or mild disease.     

Comorbidity of Migraine and Mood Episodes in a Nationally Representative Population‐Based Sample

Objective.— To examine the lifetime comorbidity of migraine with different combinations of mood episodes: (1) manic episodes alone; (2) depressive episodes alone; (3) manic and depressive episodes; (4) controls with no lifetime history of mood episodes, as well as sociodemographic and clinical correlates of migraine for each migraine–mood episode combination. Background.— Migraine has been found to be comorbid with bipolar disorder and major depressive disorder in clinical and population‐based samples. However, variability in findings across studies suggests that examining mood episodes separately may be fruitful in determining which of these mood episodes are specifically associated with migraine. Methods.— Using a cross‐sectional, population‐based sample from the Canadian Community Health Survey 1.2 (n = 36,984), sociodemographic and clinical correlates of migraine were examined in each combination of mood episodes as well as controls. Logistic regression analyses controlling for age, sex, and education level compared the lifetime prevalence of migraine (1) between controls and each combination of mood episodes, and then (2) among the different combinations of mood episodes. Results.— Migraine comorbidity in all combinations of mood episodes was associated with lower socioeconomic status, earlier onset of affective illness, more anxiety, suicidality and use of mental health resources. Compared with controls, the adjusted odds ratio of having migraine was 2.0 (95% confidence interval [CI] 1.4‐2.8) for manic episodes alone, 1.9 (95% CI 1.6‐2.1) for depressive episodes alone, and 3.0 (95% CI 2.3‐3.9) for subjects with both manic and depressive episodes. Compared with those with manic episodes alone and depressive episodes alone, the odds of having migraine were significantly increased in subjects with both manic and depressive episodes (odds ratio 1.5 vs manic episodes alone; 1.8 vs depressive episodes alone). In addition, migraine comorbidity was associated with different correlates depending on the specific combination of mood episodes; in subjects with both manic and depressive episodes, migraine comorbidity was associated with an earlier onset of mental illness, while in subjects with either manic or depressive episodes alone, migraine comorbidity was associated with increased suicidality and anxiety. Conclusions.— Migraine comorbidity appears to delineate a subset of individuals with earlier onset of affective illness and more psychiatric complications, suggesting that migraine assessment in mood disorder patients may be useful as an indicator of potential clinical severity. Differences in the prevalence of migraine as well as sociodemographic and clinical correlates associated with specific combinations of mood episodes underscore the importance of examining this comorbidity by specific type of mood episode.     

Management of Obsessive Compulsive Symptoms in a Patient Diagnosed With Bipolar 1 Disorder and a History of Migraines

Bipolar disorder and obsessive compulsive disorders (OCDs) may exist together. If the patient also experiences migraines, medication management may be complicated. Lithium and aripiprazole are prescribed as combination therapy to manage both bipolar disorder and OCD. Lamotrigine can be added for depressive symptoms and migraine prophylaxis; however, lamotrigine may exacerbate OCD symptoms. For proper medication management, advanced practice nurses will be asked to be a collaborating partner in the care of patients with both medical and psychiatric disorders.     

Exaggerated natriuretic response to isotonic volume expansion in hypertensive renal transplant recipients: evaluation of proximal and distal tubular reabsorption by simultaneous determination of renal plasma clearanceof lithium and 51Cr-EDTA

In fourteen hypertensive and fourteen normotensive renal transplant recipients, and in a group of thirteen healthy controls, changes in natriuresis, glomerular filtration rate (GFR), and tubular reabsorption of sodium were determined in relation to intravenous infusion of 2 mmol isotonic sodium chloride per kg body weight. An exaggerated natriuresis was demonstrated in the hypertensive renal transplant recipients. This new finding indicates that the augmented natriuresis following plasma volume expansion, which is a characteristic finding in subjects with arterial hypertension, is not mediated by the renal nerves. Investigation of the tubular reabsorption rates of sodium by simultaneous determination of the renal clearance of 51Cr-EDTA and lithium showed that in the hypertensives the changes in tubular handling of sodium were different from those registered in the normotensive subjects. The increased sodium excretion in the hypertensive renal transplant recipients was caused by an increased output of sodium from the proximal tubules which was not fully compensated for by an increased distal reabsorption. Whether this increased delivery of sodium to the distal segments was caused by changes in GFR or in the proximal tubular reabsorption of sodium could not be clarified in the present study and warrants further investigations.     

Determination of the renal concentration capacity following intravenous administration of dDAVP in healthy humans

The synthetic AVP analogue 1-desamino-8-d-arginine-vasopressin (dDAVP) is used for treatment of polyuric disorders. Lack of commercially available assays limits the usefulness of dDAVP as a diagnostic tool in the assessment of renal concentrating capacity. We aimed to develop a specific radioimmunoassay (RIA) for determination of plasma dDAVP (pdDAVP) in order to investigate the relationship between pdDAVP levels and urine osmolality (Uosm). Further, we aimed to determine the onset, duration, and maximum concentrating capacity following intravenous (i.v.) bolus dDAVP injection. The dDAVP assay was based on a well-established RIA for measurements of AVP. Fourteen healthy subjects (aged 15–18 years) participated. Blood and urine samples were collected prior to and after i.v. bolus of 0.03?µg/kg dDAVP. Diuresis and Uosm was measured for nine hours following dDAVP administration. PdDAVP and Uosm were analyzed.We established a specific RIA for the measurement of pdDAVP. All subjects reached maximal pdDAVP concentration (C_max) 30 minutes following infusion, and a rise in Uosm after 60 minutes. Maximal Uosm varied between subjects, with no direct correlation to the achieved pdDAVP levels. We found no significant intra-individual variation between two dDAVP infusions and the effect was reproducible in terms of C_max and maximal Uosm. We characterized the relationship between pdDAVP and Uosm after dDAVP bolus injection in healthy adolescents using our dDAVP assay. Maximal Uosm achieved correlated with the baseline Uosm levels and seemed unrelated to achieved pdDAVP levels. The urine concentrating response was maintained at least eight hours.     

Relationship between urinary concentrating ability, arginine vasopressin in plasma and blood pressure after renal transplantation

Arginine vasopressin (AVP) and serum osmolality (Sosm) were determined in plasma before and after a 24-h period of water deprivation in 19 patients with post-renal-transplant hypertension (group I), 14 patients with normal blood pressure after renal transplantation (group II), and 16 healthy control subjects (group III). Urine was collected in four periods of 6 h each for measurement of urine volume (V), urine osmolality (Uosm) and tubular capacity for reabsorption of water (Tc water). AVP and Sosm increased significantly in all groups. The AVP levels were the same in groups I and II, but higher in group I than III both before and after water deprivation. In group II, AVP was higher than in group III only after water deprivation; V was significantly reduced in all groups. In groups I and II, V, Tc water and Uosm were the same. In group III, V was significantly lower than in groups I and II in the last three 6-h periods, and in group III, Tc water was higher in the first 6-h period than in groups I and II. There was a significant positive correlation between AVP and Sosm in all groups. In conclusion, renal water excretion cannot be reduced as rapidly and to the same degree in renal transplant recipients as in control subjects because of a decreased renal capacity for reabsorption of water. The higher AVP level in the transplant recipients may be a compensatory phenomenon for the decreased responsiveness of the renal collecting ducts in the transplanted kidneys. The sensitivity of the osmoreceptors to changes in osmotic stimuli was normal.     

Relationship between urinary prostaglandin E2 and F2α excretion and plasma arginine vasopressin during renal concentrating and diluting tests in renal transplant recipients

Urinary excretion of prostaglandin E2 (PGE2 and F2 alpha (PGF2 alpha) and plasma concentration of arginine vasopressin (AVP) were determined during urinary concentrating and diluting tests in renal transplant recipients and control subjects. During the concentrating test PGE2 and PGF2 alpha remained unchanged in the renal transplant recipients, whereas both PGE2 and PGF2 alpha were significantly reduced in the control subjects. During the diluting test PGE2 and PGF2 alpha increased in both groups but, contrary to PGF2 alpha, PGE2 was significantly higher in all periods in the transplant recipients compared to the controls. However, the prostaglandin excretion rates per kidney were significantly higher in the renal transplant recipients than control subjects, for all periods during both the concentrating and the diluting test. Arginine vasopressin was significantly higher in renal transplant recipients than control subjects during basal conditions, increased to a significantly higher level in the transplant recipients after thirst, but was reduced to the same levels in the two groups during the diluting test. It is concluded that the increased excretion of prostaglandins in renal transplant recipients may be a compensatory phenomenon representing an adaptation to a reduced renal mass in order to maintain adequate renal water excretion. Although a direct relationship between the prostaglandin excretions of PGE2 and PGF2 alpha and AVP does not seem to exist, it is possible that the higher prostaglandin excretion in the renal transplant recipients may be a counterbalancing mechanism to the higher AVP level, which most likely is secondary to a decreased responsiveness to vasopressin of the renal collecting ducts in the transplanted kidney.     

Relationship between blood neutrophil‐lymphocyte ratio and renal tubular atrophy/interstitial fibrosis in IgA nephropathy patients

BackgroundThe study aimed to explore the relationship between neutrophil‐lymphocyte ratio(NLR) in peripheral blood and renal tubular atrophy/interstitial fibrosis and to evaluate the clinical significance of NLR in IgA nephropathy (IgAN) patients.MethodsA Total of 263 IgAN patients were included. The participants were categorized into four groups based on quartile of NLR. The clinical data, pathological features, and 2‐year renal survival rates were compared among the four groups. The independent factors affecting renal tubular atrophy/interstitial fibrosis in IgAN were determined by multivariate linear regression analysis.ResultsThe percentage of renal tubular atrophy/interstitial fibrosis increased with the increase of NLR level (p=0.003). The tubular atrophy/interstitial fibrosis score T1 and T2 in Group Q4 was 40%, which was higher than that of other groups, especially Group Q1 (22.73%, p=0.033) and Group Q3 (22.39%, p=0.029). NLR [β=1.230, 95%CI (0.081, 2.379), p=0.036] might be an independent factor affecting renal tubular atrophy/interstitial fibrosis in IgAN. The area under curve predicted by NLR was 0.596 (95%CI 0.534~0.656, p=0.007) with the specificity 88.24% and the optimal critical value of NLR 3.25. Fourteen patients progressed to end‐stage renal disease within 2 years, and the 2‐year survival rate of kidney was 93.49%. The renal survival rate in Group Q4 was 87.04%, lower than that in other three groups, especially Group Q1 (98.11%, p=0.029).ConclusionNLR was correlated with the level of renal tubular atrophy/interstitial fibrosis and might be a significant factor for predicting the prognosis in the IgAN.Background: IgA nephropathy (IgAN) is an important cause of the end stage renal disease (ESRD). The study aimed to explore the relationship between neutrophil‐lymphocyte ratio (NLR) in peripheral blood and renal tubular atrophy/interstitial fibrosis, and to evaluate the clinical significance of NLR in IgA nephropathy (IgAN) patients. Methods: Total 263 IgAN patients confirmed by renal biopsy pathology were included from January 2013 to May 2018 in Ningbo Hwamei Hospital, University of Chinese Academy of Sciences. The peripheral blood samples were taken from these participants and the NLR was analyzed. The participants were categorized into four groups based on the median and upper and lower quartile of NLR, which were Group Q1 (NLR<1.64), Group Q2 (1.64≤NLR<2.19), Group Q3 (2.19≤NLR<3.00), and Group Q4 (NLR≥3.00), respectively. The clinical data and pathological features were compared among four groups. The independent factors affecting renal tubular atrophy/interstitial fibrosis in IgAN were determined by multivariate linear regression analysis. The diagnostic ability of NLR for renal tubular atrophy/interstitial fibrosis was evaluated by the area under receiver operating characteristic curve (AUC). The 2‐year renal survival rates were compared among the four groups. Results: The levels of white blood cell count, neutrophil count, highly sensitive C‐reactive protein, and the percentage of renal tubular atrophy/interstitial fibrosis were increased while lymphocyte count and estimated glomerular filtration rate were decreased with the increase of NLR level (P < 0.05). The percentage of tubular atrophy/interstitial fibrosis 26%–50% (T1) and >50% (T2) in Group Q4 was 40%, which was higher than that of other groups, especially Group Q1 (22.73%) and Group Q3 (22.39%), with significant difference (P < 0.05). NLR [β = 1.230, 95%CI (0.081, 2.379), P = 0.036] might be an independent factor affecting renal tubular atrophy/interstitial fibrosis in IgAN according to multivariate linear regression analysis results. The AUC predicted by NLR was 0.596 (95%CI 0.534~0.656, P = 0.007) with the specificity 88.24%, the sensitivity 30.00% and the optimal critical value of NLR 3.25. Fourteen patients progressed to end‐stage renal disease within 2 years; and the 2‐year survival rate of kidney was 93.49%. The renal survival rate in Group Q4 was 87.04%, lower than that in other three groups, especially Group Q1 (98.11%), with significant difference (P < 0.05). Conclusion: NLR was correlated with the level of renal tubular atrophy/interstitial fibrosis and might be an significant factor for predicting the prognosis in IgAN.     

维持性血液透析患者血清vaspin水平与胰岛素抵抗的相关性研究

目的 探讨维持性血液透析患者血清vaspin的水平及其与胰岛素抵抗的关系.方法 选取我院透析中心终末期肾病维持性血液透析患者48例,测定血脂、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)等指标,并抽血测定血清vaspin、血清胰岛素(FIns)、血糖(FBG),计算胰岛素敏感指数(ISI),胰岛素抵抗指数(HOMA-IR)及腰臀比(WHR)、体质量指数(BMI),根据是否有糖尿病分为糖尿病组18例和非糖尿病组30例,同时选取30例健康体检者作为对照组,并对相关数据进行统计分析.结果 ①维持性血液透析患者血清vaspin水平较正常对照组降低,(0.91±0.36)μg/L vs (1.15±0.31) μg/L(P＜0.01).②糖尿病组和非糖尿病组两组患者的血清vaspin水平差异无统计学意义,(0.87±0.38) μg/L vs (0.97±0.34) μg/L(P＞0.05).③相关分析显示:vaspin除与BUN、Cr、UA、WHR相关外,尚与性别有关(r=-0.294、-0.284、一0.278、-0.375、0.244,P＜0.05),其中,女性vaspin水平高于男性(1.11±0.38) μg/L vs (0.93±0.33) μg/L(P＜0.05).vaspin与HOMA-IR、FIns、FBG、年龄、BMI则没有相关性(r=-0.098,-0.146,0.049,-0.095、-0.182,P＞0.05).结论 在维持性血液透析中存在有糖脂代谢紊乱和胰岛素抵抗,血清vaspin水平下降,与肾功能相关,但与胰岛素抵抗不相关.     

抑郁症双相情感障碍精神分裂症药物应用状况调查

目的：了解抑郁症、双相情感障碍及精神分裂症患者的药物应用状况。方法采用自制调查表对34例抑郁症、27例双相情感障碍及88例精神分裂症患者的药物应用状况进行统计分析。结果抑郁症以单一用药为主（94．1％）;双相情感障碍在应用情感稳定剂治疗的基础上常联合抗抑郁药物（37．0％）或抗精神病药（37．0％）治疗;精神分裂症单一用药占51．1％,联合用药占48．9％。结论抑郁症、双相情感障碍及精神分裂症患者的临床用药均符合精神药理学规范。