目的 分析蚌埠市第一人民醫(yī)院精神衛(wèi)生科米氮平門診處方中藥物相互作用情況，促進合理用藥。方法 采用回顧性研究，從信息化系統(tǒng)獲取2022年1月1日—2023年6月30日米氮平聯(lián)合用藥門診處方，分別基于Lexicomp、Medscape數(shù)據(jù)庫識別藥物相互作用，按新劃分藥物相互作用嚴重程度分級合并Lexicomp和Medscape數(shù)據(jù)庫結(jié)果。描述性統(tǒng)計米氮平相關(guān)藥物相互作用的發(fā)生率，以Kappa檢驗比較Lexicomp、Medscape、Lexicomp＋Medscape數(shù)據(jù)庫中藥物相互作用嚴重程度分級、風險點的一致性強度。結(jié)果 按納排標準得到有效處方402張，按Lexicomp、Medscape、Lexicomp＋Medscape數(shù)據(jù)庫，藥物相互作用處方分別為402張（100%）、383張（95.3%）、402張（100%）。在嚴重程度分級、風險點方面，Lexicomp＋Medscape數(shù)據(jù)庫與Lexicomp數(shù)據(jù)庫的一致性很強（Kappa＞0.99，P＝0），而Lexicomp＋Medscape數(shù)據(jù)庫或Lexicomp數(shù)據(jù)庫與Medscape數(shù)據(jù)庫有明顯差異（Kappa＜0，P＜0.05）；Medscape、Lexicomp數(shù)據(jù)庫在風險點方面有互補性。按藥品計，Lexicomp＋Medscape數(shù)據(jù)庫620例次藥物相互作用中，米氮平與丁螺環(huán)酮、抗抑郁藥帕羅西汀等的嚴重藥物相互作用（5-HT綜合征）達39.2%，應(yīng)避免聯(lián)用；與鎮(zhèn)靜催眠藥、抗精神分裂癥藥的藥物相互作用均為中度，達60.8%，應(yīng)密切監(jiān)測或換藥。結(jié)論 蚌埠市第一人民醫(yī)院米氮平與其他藥物存在嚴重、中度藥物相互作用，有必要結(jié)合Lexicomp＋Medscape數(shù)據(jù)庫，加強米氮平藥物相互作用要點培訓，采取信息化管控，防范風險。

Objective To analyze drug interactions in the outpatient prescription of mirtazapine in the department of Mental Health, Bengbu First People’s Hospital, and to promote the rational use of medication. Methods A retrospective study was conducted to obtain the outpatient prescriptions for mirtazapine co-administration in the department from January 1, 2022 to June 30, 2023 from the information system, drug interactions were identified based on Lexicomp and Medscape database, respectively, and merged according to the newly classified drug interactions severity grading. The incidence of mirtazapine-associated drug interactions was descriptive statisticed, the strength of concordance of the severity grading of drug interactions and the risk points between and among the Lexicomp, Medscape, and Lexicomp + Medscape database were tested by Kappa test. Results A total of 402 effective prescriptions were obtained according to the allotting standard, and the drug interactions prescriptions were 402 (100%), 383 (95.3%) and 402 (100%) according to Lexicomp, Medscape, and Lexicomp + Medscape database, respectively. In terms of severity classification and risk points, Lexicomp + Medscape database and Lexicomp database were strongly consistent (Kappa > 0.99, P = 0), while Lexicomp + Medscape database or Lexicomp and Medscape database were significantly different (Kappa < 0, P < 0.05). Lexicomp and Medscape database are complementary in terms of risk points. In the 620 cases of Lexicomp + Medscape database drug interactions, miltazapine, buspirone, paroxetine, and other antidepressants had severe drug interactions (5-HT syndrome) of 39.2%, which should be avoided. Drug interactions with sedative hypnotics and antischizophrenic drugs were moderate, up to 60.8%, and should be closely monitored or changed. Conclusion There are severe and moderate drug interactions between mirtazapine and other drugs in Bengbu First People’s Hospital, and it’s necessary to strengthen the training on the essentials of mirtazapine drug interactions based on the Lexicomp + Medscape database, and to adopt informational controls to prevent risks.

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