摘要
目的 探讨奎硫平治疗精神分裂症患者的血药浓度与临床疗效的关系及其临床意义。方法 70例住院精神分裂症患者,男38例,女32例;阳性和阴性症状量表(PANSS)总分≥60分,采用个体化给药,剂量范围(250～600)mg/d,疗程8周。在治疗前和治疗第1,2,4,8周末评定PANSS和治疗中需处理的不良反应症状量表。治疗第1,2,4,8周末以高效液相色谱紫外检测法测定奎硫平的血清浓度。结果 在治疗第2,4周末,血药浓度与服药剂量呈正相关(r=0.248和0.347,P<0.05和P<0.01);血药浓度与PANSS减分率呈正相关(r=0.343和0.499,P<0.05和P<0.01)。有效组的血药浓度高于无效组,分别为(320±142)μg/L和(251±109)μg/L(P<0.01)。奎硫平最低有效浓度为250μg/L,有效组(44例)中75％在此浓度以上,无效组(26例)中80％低于此浓度;最低有效剂量为344 mg/d。结论 奎硫平治疗精神分裂症的疗效与血药浓度有相关性,其最低有效阈浓度为250μg/L,血药浓度测定对指导临床用药具有实际意义。
Objective To explore the relationship between serum concentration and clinical efficacy of quetiapine in the treatment of patients with schizophrenia. Methods The subjects were 70 inpatients with Positive and Negative Symptom Scale (PANSS) score of at least 60 before treatment. They were treated with quetiapine for 8 weeks, with the dosage range of 250 mg to 600 mg daily. The clinical efficacy and side effects were assessed with the PANSS and Treatment Emergent Symptom Scale before and at the 1st, 2nd, 4th and 8th weekend of treatment. The blood samples were gotten at the 1st, 2nd, 4th and 8th weekend of treatment, and the serum concentration of quetiapine was determined with high performance liquid chroma-tography. Results The serum concentration had significant positive correlation with the dose of quetiapine (r = 0. 248-0. 347 , P < 0. 05-0. 01) . The responsive rate in patients with serum concentration of over 250 μg/L was 75%. The serum concentration in responsive patients was (320 ± 142) μg/L, significant higher than that in non-responsive patients (251± 109)μg/L The serum concentration was positively correlated to the reduction of PANSS score (r = 0. 343 - 0. 499, P<0. 05-0.01). The lowest mean effective dosage was 344 mg per day. Conclusion Quetiapine is effective for schizophrenia and the clinical efficacy is related to its serum concentration. The lowest appropriate serum concentration of quetiapine is 250 μg/L It is of significance for monitoring serum concentration of quetiapine in treatment of schizophrenia.
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2004年第2期85-87,共3页
Chinese Journal of Psychiatry
