氯氮平血药浓度及其有关因素分析

目的：探讨服用氯氮平平时的血药浓度及其与剂量、疗效不良反应之间的关系。方法：回顾分析了763例用氯氮平治疗的住院精神病患者的一般资料、氯氮平用药剂量及其血药浓度、诊断、临床疗效和不良反应等情况。结果：精神分裂症患者与神经症、抑郁症及反应性精神病患者之间用药剂量的差异有显著意义，老年患者的治疗剂量明显低于其他年龄组（P＜0．05）。用＞150－350mg/d的治疗剂量和／或氯氮平血药浓度200－500ng/ml时，疗效相对较好。女性的稳态血药 浓度显著高于男性患者。结论：监测氯氮平治疗血药浓度，有助于调整剂量，减少不良反应和了解药物的相互作用，可为氯氮平治疗精神疾病提供重要参考。

The plasma concentration of clozapine and its correlates

Objectives: The aim of study was to analyze the relationships between the drug plasma concentration and the dosage, clinical efficacy, side effects. Method: 763 hospitalized mentally ill patients treated with clozapine were retrospectively investigated, regarding their diagnoses, drug dosage, clozapine plasma concentration, efficacy and adverse reactions. Results: There were significant differences in clozapine dosage among the diagnoses. The dosage in elderly patients was statistically lower than that in others. The more effective outcome was showed in patients administrated with clozapine ranged from 150 mg/d to 350 mg/d and/or in patients with plasma concentraton ranged from 200 ng/ml to 500 ng/ml. Stable plasma concentration of clozapine in female patients was statistically higher than that in male ones. Conclusion: Monitoring the plasma stable state concentration of clozapine is helpful for improving efficacy , adjusting the treatment dosage, reducing adverse ractions and understanding drug interaction.