摘要
目的探讨中、小剂量利培酮治疗精神分裂症患者的血药浓度、临床疗效及不良反应。方法将82例精神分裂症患者随机分为口服利培酮剂量2mg/d组和4mg/d组。采用RP-HPLC和LC-MS方法测定利培酮(RSP)和9-羟利培酮(9-OH-RSP)之和的血浆浓度。用阳性和阴性症状量表(PANSS)评定临床疗效,用不良反应症状量表(TESS)评定不良反应。结果4mg/d组(RSP+9-OH-RSP)血浓度均显著高于2mg/d组。2mg/d组第1周末PANSS平均减分率<20%,其它各周末PANSS平均减分率>20%,而4mg/d组各周末PANSS平均减分率>20%.2mg/d组TESS评分明显低于4mg/d组。结论(RSP+9-OH-RSP)血浓度能较好地反映其临床效应。2mg/d和4mg/d利培酮治疗精神分裂症患者疗效相当,4mg/d利培酮治疗时起效更快,但易发生不良反应。
Objective To compare the plasma concentration , clinical efficacy and side effects of risperidone between middle - dose and small - dose in the treatment of first - episode schizophrenia. Methods A total of 82 patients with schizophrenia were randomly divided into two groups, 2mg/d group and 4mg/d group. The plasma concentration of ris- peridone and 9 - hydroxy risperidone was measured by RP - HPLC and LC - MS. The clinical efficacy was evaluated with Positive and Negative Symptoms Scale （PANSS） and side effects with Treatment Emergent Symptom Scale （TESS）. Re- suits The plasma concentration of risperidone and 9 - hydroxy risperidone in 4mg/d group was significantly higher than that in 2mg/d group. The reduced rate of PANSS was less than 20% on the 1st weekend and over than 20% on the 2nd weekend after treatment in 2mg/d group. While the reduced rate of PANSS was over 20% from 1 st weekend after treat- ment in 4mg/d group. The score of TESS in 2mg/d group was significantly lower than that in 4mg/d group. Conclusion The plasma concentration of risperidone and 9 - hydroxy risperidone may be a good index for clinical efficacy. 4mg/d and 2mg/d have similar efficacy, but 4mg/d takes into effect quickly and has more side effects.
出处
《精神医学杂志》
2009年第5期337-338,共2页
Journal of Psychiatry
基金
山东省医药卫生科研项目
项目编号2001CA1DFB1
关键词
精神分裂症
利培酮
血药浓度
疗效
不良反应
Schizophrenia Risperidone Plasma concentration Efficacy Side effect
