影响氯丙嗪与氯氮平血药浓度的相关因素分析

目的探讨影响氯丙嗪与氯氮平血药浓度的相关因素。方法选择维持治疗期精神分裂症患者为对象，并采用氯丙嚎、氯氮平和两者合用（双氯组）3个组，每组各20例精神分裂症患者分别进行治疗，同时分析血药浓度与人口学特征、药物剂量及临床症状的关系。结果单用氯丙嚎和采用氯氮平组的血药浓度均与年龄相关（P〈0．05），氯氮平血药浓度与剂量线性正相关（P=0．01）；在双氯组中的氯丙嗪血药浓度与剂量线性正相关（P〈0．01），与PANSS总分及一般精神病理分相关（P=0．01），而氯氮平血药浓度与PANSS总分、阴性量表分及一般精神病理分明显相关（P〈0．05）；多元回归分析显示，治疗形式和治疗方法影响氯丙嗪血药浓度，年龄和治疗方法影响氯氮平血药浓度。结论维持治疗期血药浓度监测有利于合理用药和预防复发。

An analysis of influential factors on the serum drug concentration of chlorpromazine and clozapine

Objective To analyse the influential factors on the serum drug concentration of chlorpromazine and clozapine.Method 60 schizophrenic patients during maintenance treatment including chlorpromazine group,clozapine group and combination group,and then analyze the relationships between serum drug concentration and demographic characteristics,drug dosage,clinical characteristics.Results For single treatment groups,serum drug concentration of chlorpromazine and clozapine were related to age of patients(P<0.05),concentration of clozapine was related to dosage(P=0.01).For combination group,concentration of chlorpromazine was related to dosage(P<0.01),also related to scores of PANSS and general psychopathological symptoms(P=0.01),concentration of clozapine was related to scores of PANSS,negative and general psychopathological symptoms(P<0.05).Multiple linear regression analysis showed that forms and methods of treatment affected concentration of chlorpromazine,age of patients and methods of treatment affected concentration of clozapine.Conclusion Monitoring serum drugs concentration during maintenance treatment is recommended.