氯氮平治疗精神分裂症患者期间不同血药浓度对治疗效果的影响  

Effect of Different Blood Drug Concentrations on the Therapeutic Effect of Clozapine in the Treatment of Schizophrenia Patients

作　　者：董建丽 马燕 葛海瑞 李文学 DONG Jianli;MA Yan;GE Hairui;Li Wenxue(Department of Clinical Laboratory,Henan(Zhengzhou)Zhonghui Central Cardiovascular Hospital,Zhengzhou 450006,Henan,China;Department of Clinical Laboratory,the Eighth People's Hospital of Zhengzhou,Zhengzhou 450000,Henan,China)

机构地区：[1]河南(郑州)中汇心血管病医院检验科,河南郑州450006 [2]郑州市第八人民医院检验科,河南郑州450000

出　　处：《中国药物滥用防治杂志》2025年第1期25-28,共4页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：河南省科技发展计划项目(编号:182102310657)。

摘　　要：目的:探讨不同氯氮平血药浓度对精神分裂症(SC)患者疗效、血糖-胰岛素稳态的影响。方法:回顾性分析2022年3月—2024年10月在河南(郑州)中汇心血管病医院接受氯氮平治疗的120例SC患者临床资料,依据不同氯氮平血药浓度检测结果分为低浓度组(40例,血药浓度<350μg/L)、中浓度组(40例,350μg/L≤血药浓度≤600μg/L)与高浓度组(40例,血药浓度>600μg/L),对比3组治疗3个月后临床疗效、血糖-胰岛素稳态及脂代谢指标水平。结果:治疗3个月后,高浓度组及中浓度组治疗总有效率高于低浓度组(P<0.05);中浓度组治疗总有效率与高浓度治疗总有效率比较,差异无统计学意义(P>0.05);三组治疗3个月后糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)水平均较治疗前升高,高密度脂蛋白胆固醇(HDL-C)水平均较治疗前下降,且高、中浓度组HbA1c、FINS、FBG、HOMA-IR水平高于低浓度组,高浓度组水平高于中浓度组,中、低浓度组HDL-C水平均高于高浓度组,低浓度组水平高于中浓度组(P<0.05)。结论:与高、低血药浓度相比,中等氯氮平血药浓度可在保证临床疗效的前提下,减轻对SC患者血糖-胰岛素稳态及脂代谢的影响。Objective:To investigate the effects of different clozapine plasma concentrations on the efficacy and blood glucose-insulin homeostasis in patients with schizophrenia(SC).Methods:The clinical data of 120 patients with SC who received clozapine treatment in Henan(Zhengzhou)Central Cardiovascular Hospital from March 2022 to October 2024 were retrospectively analyzed.According to the results of different clozapine blood concentration test,the patients were divided into low concentration group(40 patients,blood concentration<350μg/L),medium concentration group(40 patients,350μg/L≤blood concentration≤600μg/L)and high concentration group(40 patients,blood concentration>600μg/L).The clinical efficacy,blood glucose-insulin homeostasis and lipid metabolism indexes of the three groups after 3 months of treatment were compared.Results:After 3 months of treatment,the total effective rate of treatment in the high concentration group and the medium concentration group was higher than that in the low concentration group(P<0.05),while there was no significant difference in the total effective rate between the medium concentration group and the high concentration group(P>0.05).After 3 months of treatment,the levels of glycosylated hemoglobin(HbA1c),fasting insulin(FINS),fasting blood glucose(FBG)and insulin resistance index(HOMA-IR)in the three groups were higher than those before treatment,and the levels of high-density lipoprotein cholesterol(HDL-C)were lower than those before treatment,while the levels of HbA1c,FINS,FBG and HOMA-IR in the high and medium concentration groups were higher than those in the low concentration group,and the levels in the high concentration group were higher than those in the medium concentration group,the levels of HDL-C in the medium and low concentration groups were higher than those in the high concentration group,and the levels in the low concentration group were higher than those in the medium concentration group(P<0.05).Conclusion:Compared with high and low plasma concentrations,mediu

关 键 词：精神分裂症 氯氮平 不同血药浓度 血糖-胰岛素稳态 

分 类 号：R969.1[医药卫生—药理学]