精神障碍患者氯氮平血药浓度与实验室临检指标的关系研究  

The relationship between blood clozapine concentration and laboratory test indexes in patients with mental disorders

作　　者：周哲明 李芳 易庆 Zhou Zheming;Li Fang;Yi Qing(Yichun Third People's Hospital,Jiangxi 336000)

机构地区：[1]宜春市第三人民医院,江西336000

出　　处：《天津药学》2024年第3期48-51,共4页Tianjin Pharmacy

摘　　要：目的:探讨精神障碍患者氯氮平血药浓度与实验室临检指标的关系。方法:选择2021年6月—2023年6月本院收治的精神障碍患者180例,所有入选者均服用相同剂量的氯氮平。用药后检测患者氯氮平血药浓度以及实验室相关指标。比较不同血药浓度患者各项实验室指标,包括高密度脂蛋白(HDL)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、谷氨酸氨基转移酶(ALT)、谷氨酰转肽酶(GGT)、低密度脂蛋白(LDL)、乳酸脱氢酶(LDH)、直接胆红素(DBIL)、甘油三酯(TC)、总胆固醇(TG)。另外分析氯氮平血药浓度与各项实验室指标的关系。结果:高浓度组LDL和TG均高于正常浓度组与低浓度组,差异有统计学意义(P<0.05),正常浓度组与低浓度组LDL和TG比较,差异无统计学意义(P>0.05);三组HDL、AST、TBIL、CK、CKMB、ALT、GGT、LDH、DBIL和TC比较,差异无统计学意义(P>0.05)。经Pearson相关性分析发现,LDL、TG与氯氮平血药浓度均呈正相关(r>0,P<0.05)。结论:精神障碍患者采用氯氮平治疗时LDL、TG指标与血药浓度有密切关系,当上述指标水平异常升高时应检测血药浓度,可作为调整药动力学参数的参考指标。Objective:To investigate the relationship between blood clozapine concentration and laboratory test indices in patients with mental disorders.Methods:A total of 180 patients with mental disorders who were admitted to our hospital between June 2021 and June 2023 were selected,all of whom received the same dose of clozapine.Blood concentrations of clozapine and related laboratory indices,including high-density lipoprotein(HDL),aspartate aminotransferase(AST),total bilirubin(TBIL),creatine kinase(CK),creatine kinase isoenzyme(CKMB),glutamate aminotransferase(ALT),glutamyl transpeptidase(GGT),low-density lipoprotein(LDL),lactate dehydrogenase(LDH),direct bilirubin(DBIL),triglyceride(TC),and total cholesterol(TG),were measured after medication.In addition,the relationship between the blood concentration of clozapine and various laboratory indices was analyzed.Results:LDL and TG levels in the high concentration group were higher than those in the normal and low concentration groups,and the differences were statistically significant(P<0.05).There was no statistically significant difference in LDL and TG levels between the normal and low-concentration groups(P>0.05).There were no statistically significant differences in HDL,AST,TBIL,CK,CKMB,ALT,GGT,LDH,DBIL,and TC levels among the three groups(P>0.05).Pearson's correlation analysis showed that LDL,TG,and clozapine blood concentrations were positively correlated(r>0,P<0.05).Conclusions:There is a close relationship between LDL and TG indicators and blood drug concentrations in patients with mental disorders treated with clozapine.When the levels of these indicators are abnormally elevated,the blood drug concentration should be detected as a reference indicator for adjusting pharmacokinetic parameters.

关 键 词：精神障碍 氯氮平 血药浓度 实验室临检指标 

分 类 号：R969[医药卫生—药理学] R749[医药卫生—药学]