上呼吸道感染对精神分裂症患者氯氮平血药浓度的影响  

Effect of upper respiratory tract infection on clozapine concentration in schizophrenic patients

作　　者：杜瑜[1] 王淼[2] 陈彬彬 DU Yu;WANG Miao;CHEN Bin-bin(Department of Pharmacy,Zhongshan Hospital Affliated to Xiamen University,Fujian Xiamen 361004,China;Department of Respiratory Medicine,Zhongshan Hospital Affliated to Xiamen University,Fujian Xiamen 361004,China;Department of Pharmacy,Xiamen Xianyue Hospital,Fujian Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院药学部,福建厦门361004 [2]厦门大学附属中山医院呼吸内科,福建厦门361004 [3]厦门市仙岳医院药学部,福建厦门361004

出　　处：《中国医院药学杂志》2020年第16期1710-1713,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:分析上呼吸道感染与精神分裂症患者的氯氮平(clozapine,CLZ)血药浓度、不良反应三者的相关性。方法:纳入35例CLZ稳定治疗的精神分裂症伴有上呼吸道感染的住院患者,分别采集感染前后清晨服药前的空腹血,采用HPLC-MS测定CLZ稳态谷浓度。结果:35例患者在感染后CLZ血药浓度有不同程度的升高,基线期平均血药浓度为(481.6±258.0)μg·L^-1,感染期平均血药浓度为(853.8±452.4)μg·L^-1。17例患者发生了CLZ血药浓度升高后的不良反应,其中最多的是精神性不良反应。结论:上呼吸道感染对CLZ血药浓度的升高有一定影响,并导致不良反应的发生。所以住院感染期间CLZ血药浓度的监测是至关重要的,同时应注意剂量的调整,减少不良反应发生的风险。OBJECTIVE To analyze the correlation between upper respiratory tract infection and clozapine(CLZ)plasma concentration and adverse reactions in patients with schizophrenia.METHODS Thirty-five schizophrenic patients with upper respiratory tract infection treated with CLZ were enrolled in this study.Fasting blood samples were collected before and after treatment in the morning.The steady trough concentration of CLZ was determined by HPLC-MS.RESULTS The plasma concentration of CLZ in 35 patients increased to some extent after infection.The mean plasma concentration was(481.6±258.0)μg·L^-1 at baseline and(853.8±452.4)μg·L^-1 at infection.Seventeen patients experienced adverse effects after increased plasma concentrations of CLZ,the largest of which were psychiatric adverse effects.CONCLUSION Upper respiratory tract infection has a certain impact on the increase of clozapine blood concentration,which can lead to adversereactions.Therefore,the monitoring of clozapine blood concentration during hospital infection is very important.We should pay attention to the dose adjustment to reduce the risk of adversereactions.

关 键 词：感染 氯氮平 精神分裂症 血药浓度 

分 类 号：R969[医药卫生—药理学]