氯氮平血药浓度与临床效应关系探讨

对50例经氯氮平治疗的精神分裂症患者作血药浓度测定,并以BPRS、CGI、TESS量表评定作临床效应分析。结果表明:氯氮平口服剂量与血浓度间里正相关;治疗结束时,血药浓度与BPRS评分间里负相关;治疗有效血浓度阈值为400ng/ml(敏感度75％;特异度80％);血浓度与TESS评分间关系不明显;脑电图异常率与口服剂量、血浓度间呈正相关,且与后者的关系更明显;氯氮平所致白细胞计数异常现象与血药浓度高低无关。

Clozapine plasma concentration and clinical response in schizophrenic patients treated with clozapine.

This paper reports the relation between plasma concentration and clinical response of schizophrenic patients treated witl clozapine (CZP). 50 patients were studied and13 Of them were withdrawn for severe adverse reacticis. The result showed a positive relation between ore. dosage and plasma concentration of CZP existed (p<0.05). And there was a negative correlation between CZP plasma concentration and BPRS scores (p<0.01). A receiver operating curve demonstrated that the threshold of CZP plasma concentration for therapeutic response was 400ng/ml, its sensitivity was 75% and specificity was 80%. The relation between CZP plasma concentration and TESS scores was not found (p> 0.05).However,the correlation between the incidence of abnormality in EEG and CZP oral dosage and plasma concentration was significant, and the latter was more (r = 0.98, p<0.01). In our study, the incidence of leukocytosis and leukopenia was independent of the degree of plasma concentration.