精神分裂症患者氯氮平血药浓度与血清同型半胱氨酸水平的相关性  

Correlation analysis of serum clozapine concentration with serum homocysteine level in schizophrenic patients

作　　者：路钊 贺静 陈英 李文标 LU Zhao;HE Jing;CHEN Ying;LI Wenbiao(Clinical Examination and Experimental Center,The National Clinical Research Centre far Mental Disorder&Beijing Key Lab of Mental Disorders,Beijing Anding Hospitalf Capital Medical University,Beijing 100088,China)

机构地区：[1]首都医科大学附属北京安定医院,国家精神心理疾病临床医学研究中心,精神疾病诊断与治疗北京重点实验室,临床检验科

出　　处：《中国神经精神疾病杂志》2019年第10期602-606,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：首都临床特色应用研究与成果推广项目(编号：Z171100001017075)

摘　　要：目的研究使用氯氮平治疗的精神分裂症患者氯氮平血药浓度与血清同型半胱氨酸(homocysteine,Hcy)及生化指标水平的相关性。方法收集使用氯氮平治疗的241例精神分裂症患者,检测其氯氮平血药浓度、血清Hcy水平及生化指标,根据氯氮平血药浓度分为高浓度组(41例)、正常浓度组(86例)和低浓度组(114例),比较3组患者的血清Hcy及其他生化指标水平,分析血药浓度与血清Hcy及生化指标的相关性。结果氯氮平血药高浓度组的Hcy、TG、LDL水平均高于低浓度组(P<0.05)和正常浓度组(P<0.05),正常浓度组与低浓度组间Hcy、TG、LDL水平差异均无统计学意义(P>0.05)。氯氮平血药浓度与血清Hcy(r=0.221,P=0.013)、TG(r=0.193,P=0.003)、LDL(r=0.148,P=0.021)水平存在统计学相关性。结论氯氮平治疗的精神分裂症患者血清Hcy、TG、LDL水平与药物浓度可能相关,提示对血清Hcy、TG、LDL水平升高的患者应监测其血药浓度。Objective To analysis the correlation of serum clozapine concentration with serum homocysteine(Hcy) level and biochemical index in schizophrenic patients. Methods Two hundred and forty one schizophrenic patients treated with clozapine in Beijing Anding Hospital from January 1 st 2017 to January 31 st 2018 were enrolled in the study.Serum clozapine concentration, Hcy levels and biochemical index were measured. Patients were divided into high concentration group(n=41), normal concentration group(n=86) and low concentration group(n=114) according to serum clozapine concentration. The correlation of serum clozapine concentration with Hcy level and biochemical index was analyzed. Results The levels of Hcy, TG and LDL were higher in high clozazapine concentration group than in low concentration group and in normal concentration group(P <0.05). There was no significant difference between normal group and low concentration group in Hcy, TG and LDL levels(P >0.05). High serum clozapine concentration was positively correlated with serum Hcy(r =0.221, P =0.013), TG(r =0.193, P =0.003) and LDL level(r =0.148, P =0.021).Conclusion Serum levels of Hcy, TG and LDL in schizophrenic patients treated with clozapine are correlated with drug concentration, suggesting that patients with abnormally elevated levels of Hcy, TG and LDL should be monitored.

关 键 词：精神分裂症 氯氮平 同型半胱氨酸 

分 类 号：R749.3[医药卫生—神经病学与精神病学]