氯氮平治疗精神分裂症临床疗效与血浓度再分析  

The clinical effects and plasma concentration analysis of the treatment of schizophrenic with Clozapine

作　　者：彭星星 钟潇琦[2] 姜南[2] 郑洪波[2] 

机构地区：[1]阳江市复退军人医院,广东阳江529500 [2]广州市精神病医院

出　　处：《中国民康医学》2010年第11期1383-1384,1386,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨氯氮平治疗精神分裂症的临床效应与剂量、血药浓度的关系。方法:用不同剂量氯氮平治疗精神分裂症64例(A组200mg/日,22例;B组400mg/日,24例;C组600mg/日,18例),用简明精神症状评定量表(BPRS)和临床总体印象量表(CGI)及副反应量表(TESS)评定疗效及不良反应,并测定治疗第2、4、8周末晨服药前的稳态血浓度,共观察8周。结果:(1)三组比较总有效率,BPRS总减分率,TESS增分值均有显著差异(P<0.05);(2)氯氮平血浓度与剂量呈正相关;(3)血浓度与结束时BPRS评分之间呈负相关(P<0.05);(4)高剂量组不良反应明显大于低剂量组(P<0.05);(5)血浓度与TESS评分之间的关系尚不能确定(P>0.05)。结论:推荐单用氯氮平治疗精神分裂症的稳态血药浓度为400μg/L左右。Objective： To explore the relationship of the treatment of schizophrenic with Clozapine between the clinical effects and plasma concentration ＆ dose. Methods：64 schizophrenic patients treated with Clozapine were divided into Group A （200mg/day, 22 cases） , Group B （400mg/day, 24 cases） and Group C （600mg/day, 18 cases） randomly. The clinical effects and side effects were observed by the BPRS, CGI and TESS. Meanwhile, the steady plasma concentrations before the treatment of the 2nd, 4th and 8th weekend were observed within a total of 8 weeks. Results ： 1 ）. There are significant differences in the above three groups by comparing their overall efficacy rate, BPRS reduction rate and TESS （ P 〈 0.05 ） ; 2）. The plasma concentration and dose show the positive corre- lation ; 3 ）. The plasma concentrations and BPRSg scores show negative correlation （ P 〈 0.05 ） ; 4）. The side effects in the group with high dose is significant higher than the group with low dose （P 〈 0.05 ） ; 5 ）. The relationship between plasma concentration and TESS is not to be confirmed now （P 〉 0.05 ）. Conclusions： The steady plasma concentration of 400μg/L is to be recommended to treat schizophrenic with Clozapine only.

关 键 词：精神分裂症 氯氮平 血药浓度 

分 类 号：R749.3[医药卫生—神经病学与精神病学]