中、小剂量利培酮治疗首发精神分裂症患者的血药浓度与疗效关系的对照研究  

Relationship of plasma concentration and efficacy of risperidone in the treatment of first-episode schizophrenia.

作　　者：由炜[1] 付崇铭[1] 米国琳[1] 

机构地区：[1]山东省精神卫生中心,济南250014

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

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.

关 键 词：精神分裂症 利培酮 血药浓度 疗效 不良反应 

分 类 号：R749.3[医药卫生—神经病学与精神病学]