喹硫平治疗男性精神分裂症患者血药浓度与临床疗效、血清神经功能指标的相关性分析  

Correlation between plasma concentration and clinical efficacy,Serum nerve function indexes of Quetiapine in the male patients

作　　者：赵燕[1] 王在亮[1] 吴华[1] 公维谦 

机构地区：[1]山东省泰安市复员退伍军人精神病院,泰安271000

出　　处：《国际精神病学杂志》2017年第2期219-221,225,共4页Journal Of International Psychiatry

摘　　要：目的探讨喹硫平治疗男性精神分裂症患者血药浓度、临床疗效以及血清神经功能指标的相关性。方法选择我院收治的男性精神分裂症患者95例为研究组,同期来我院体检的健康男性志愿者85例为对照组。测定患者治疗前后血清神经元特异性烯醇化酶(NSE)、手型钙结合蛋白(S100B)及脑源性神经营养因子(BDNF)水平,测定不同时间点的患者血浆喹硫平含量。分析治疗前后两组患者NSE、S100B、BDNF变化水平及其与喹硫平血药浓度的相关性,并研究喹硫平血药浓度与临床疗效的关系。结果经非线性回归分析,BPRS%减分率>30%时,研究组患者喹硫平血药浓度范围为130~360 ng·mL^(-1),服药剂量范围为160~500 mg·d-1。治疗第6周末,喹硫平血药浓度和患者临床疗效有明显的统计学相关性(P<0.05)。研究组治疗前血清NSE与S100B水平高于对照组(P<0.05),BDNF水平低于对照组(P<0.05);与治疗前比,治疗后各个时间点研究组血清NSE与S100B水平明显下降,BDNF水平显著上升(P<0.05)。治疗各个时间点研究组患者喹硫平血药浓度与血清NSE、S100B和BDNF相关(P<0.05)。结论 NSE、S100B、BDNF水平与喹硫平的治疗机制有关。喹硫平治疗男性精神分裂症患者的起效血药浓度可能为130 ng·mL^(-1)。Objective To study the relationship among plasma concentration of quetiapine, serum nerve function indexes and clinical efficacy in patients with schizophrenia. Methods A total of 95 male patients with schizophrenia in our hospital were selected as the study group, 85 healthy persons at the same time were selected as the control group. The relationship among plasma concentration of quetiapine, serum nerve function indexes and clinical efficacy in pa-tients with schizophrenics were analyzed. Results Nonlinear regression analysis showed when BPRS% reduction rate 〉 30 %, serum concentration range of patients in patients was 130 - 360 ng·mL^-1, and dose range was 160 - 500 mg. d^-1. At the 6th weekend, there was a significant statistical correlation between the serum concentration and the clinical efficacy in the patients （P〈0.05） . The serum levels of NSE, SI00B in study group were higher than those in control group, serum levels of BDNF was lower than those of control group （ P 〈 0.05 ） . The quetiapine plasma concentration was closely related to serum nerve function indexes in the study group （P〈0.05） . Conclusion The NSE, S100B and BDNF maybe play the important role in cure quetiapine and pathogenesis of schizophrenia. The lowest effective serum concentration of quetiapine in male patients with schizophrenia was 130 ng.mL^-1.

关 键 词：喹硫平 男性 精神分裂症 血药浓度 临床疗效 神经功能指标 

分 类 号：R749.3[医药卫生—神经病学与精神病学]