摘要
目的:对精神分裂症患者服用奥氮平的血药浓度进行监测,观察临床疗效与血药浓度之间的关系。方法:65例精神分裂症患者,单用奥氮平治疗8周;采用高效液相色谱法(HPLC)监测血药浓度,同时记录剂量、疗效和不良反应。结果:奥氮平剂量5～25 mg,血药浓度为3.0～86.0μg/L,平均(25.5±13.5)μg/L,药物剂量与血药浓度呈正相关(r=0.582)。血药浓度<10μg/L者13例,10～20μg/L者43例,>20μg/L者9例,其显效率分别为5例(38.5%)、33例(76.7%)和6例(66.7%)。<10μg/L与>10μg/L的显效率以后者显著较高(P<0.05);而10～20μg/L与>20μg/L之间差异无显著性(P>0.05)。血药浓度<10μg/L有2例(15.0%),10～20μg/L有23例(53.0%),>20μg/L有8例(89.0%)发生了不良反应,3组比较差异有显著性(P<0.01)。结论:奥氮平治疗精神分裂症的血药浓度以10～20μg/L较为适宜,疗效较好,不良反应较少。
Objective： To monitor the plasma concentration of olanzapine in patients with schizophrenia and investigate the relationship between clinical efficacy and plasma level of olanzapine. Method ：65 patients with schizophrenia were treated with olanzapine for 8 weeks and the plasma concentration of olanzapine was measured by high performance liquid chromatography （HPLC） , with doses of olanzapine, clinical efficacy and adverse effects being recorded. Results ：The plasma concentration of olanzapine was 3.0 μg/L to 86.0 μg/L when patients took olanzapine 5 - 25 mg/day. There was a positive relationship between olanzapine doses and the plasma concentration （r =0.582）. 13 patients had plasma concentration 〈 10 μg/L, 43 patients in range of 10 - 20 μg/L and 9 patients 〉 20 μg/L, with response rate 38.5 % （ 5 cases） , 76.7 % （ 33 cases） and 66.7 % （6 cases）, respectively. The patients with plasma concentration of olanzapine 〉 10 μg/L had higher response rate compared with those 〈 10 μg/L （P 〈0.05）. However, there was no significant difference in the response rate between patients with plasma concentration in range of 10 - 20 μg/L and that 〉 20 μg/L （ P 〉 0.05 ）. Significant differences appeared in adverse effects among the three groups, with 2 patients（ 15.0% ） in 〈 10μg/L group, 23 patients（53.0% ） in range of 10 -20 μg/L group and 8 patients （89.0%）in 〉20 μg/L group （P 〈 0.01 ） . Conclusion ： The plasma concentration of olanzapine in range of 10 - 20 μg/L was suitable for the treatment of schizophrenia, with better efficacy and less adverse effects.
出处
《临床精神医学杂志》
2008年第6期379-380,共2页
Journal of Clinical Psychiatry
基金
江苏省无锡市科学基金项目(HS20020011)
关键词
精神分裂症
奥氮平
血药浓度监测
schizophrenia
olanzapine
monitor the plasma concentration
