摘要
目的 :探讨氯丙咪嗪治疗抑郁症的口服剂量、血药浓度与临床疗效之间关系 ,及其有效血浓度范围。 方法 :符合 CCMD- 2诊断标准的抑郁症病人 30例 ,汉密尔顿抑郁量表 (HAMD)评分2 1～ 45分 ,平均 (34.87± 6 .5 3)分 ;纽卡斯尔抑郁诊断量表 (NDI)评分 6～ 10分进入研究。以不定剂量氯丙咪嗪口服治疗 ,共治疗 8周。以 HAMD减分率评定疗效。荧光免疫偏振分析仪 (TDx)测第14天稳态血药浓度。 结果 :氯丙咪嗪剂量 2 5～ 10 0 m g/ d时血浓度范围变异很大 [46～ 44 7ng/ ml,平均 (183± 86 ) ng/ m l];口服剂量与血药浓度呈非线性相关 (P<0 .0 5 ) ;血药浓度与临床疗效显著相关(r=- 0 .5 5 2 ,P=0 .0 0 16 ) ,呈指数曲线关系。 结论 :氯丙咪嗪有效血浓度在 12 6～ 40 0 ng/ ml之间 。
Objective:To investigate the relationship among the oral dose,serum level and the clinical response in the depressive outpatients with clomipramine,and to discover its therapeutic concentration range. Method:Thirty outpatients who met CCMD 2 criteria for depression,with Hamilton depression rating scale (HAMD 24 items) scores 21~45(34 87±6 53) and Newcastle scale scores 6~10,were entered in the study.During a treatment of eight weeks,the patients were orally administered various doses.Clinical response was evaluated with the reduction rate of HAMD scores.Serum levels were measured on Day 14 when serum concentration reached steady state with fluorescence polarization immunoassay analyzer (TDx). Results:There were great variations of serum concentrations in 30 outpatients with 25~100mg per day of clomipramine [46～447ng/ml,mean(183±86)ng/ml].Serum concentration had a non linear correlation with the drug does ( P <0 05),however,had an exponential curve relationship with clinical response.In addition,there was a significant correlation between serum concentration and response ( r=-0 552,P =0 0016). Conclusion:The therapeutic concentration range of clomipramine is 126~400ng/ml.Long term oral administration ought to be directed by monitoring serum level.
出处
《临床精神医学杂志》
2000年第5期257-259,共3页
Journal of Clinical Psychiatry
