阿立哌唑治疗精神分裂症血药浓度与临床疗效的相关性研究

目的探讨阿立哌唑在精神分裂症患者中的血药浓度与临床疗效的关系。方法采用高效液相色谱的方法测定52例精神分裂症患者体内阿立哌唑的血浆药物浓度，采用阳性和阴性综合征量表（PANSS）评定疗效。结果治疗后第1、2、3、4周末与治疗前比较PANSS量表总分及各因子分均显著降低（P〈0．05）。阿立哌唑在治疗后第3周末达到稳态血药浓度，治疗后第3周末有效率为71．2％。治疗后第1、2、3、4周末血药浓度与对应周的剂量呈正相关（P〈0．05）；治疗后第1、2、3、4周末血药浓度与对应周的PANSS量表评分无相关性（P〉0．05）；治疗后第3周末将阿立哌唑血药浓度分成低浓度组（≤76μg／L）、中浓度组（76～116μg／L）、高浓度组（〉116μg／L）3组，中、低浓度组PANSS评分大于高浓度组，但3组差异无统计学意义（P〉0．05）。结论阿立哌唑治疗精神分裂症的血药浓度与其临床疗效之间无相关性。

Correlation analysis between plasma concentration of aripiprazole and clinical efficacy for schizophrenia.

Objective To study the relationship schizophrenia. Methods 52 schizophrenic patients by using the Positive and Negative Syndrome Scale high- performance liquid chromatography. Results between plasma concentration of aripiprazole and clinical efficacy for were treated with aripiprazole and the clinical efficacy was evaluated （PANSS）. Plasma concentration of aripiprazole was measured with Total score and factor scores of PANSS at the end of the 1 st, 2nd, 3rd, 4th week of the treatment decreased significantly when compared with the baseline （P 〈0.05）. At the end of the 3rd week of the treatment, steady plasma drug concentration of aripiprazole was obtained and the effective rate was 71.2%. Plasma concentration of aripiprazole at the end of the 1st, 2nd, 3rd and 4th week was positively correlated with the dosage at each corresponding time-point （P 〈 0.05）. Plasma concentration of aripiprazole at the end of the 1st, 2nd, 3rd, 4th week Showed no significant correlation with score of PANSS at each corresponding time-point （P 〉 0.05）. At the end of the 3rd week of the treatment, patients were divided into low concentration group （ ≤76 μg/L）, moderate concentration group （76- 116 μg/L） and high concentration group （ 〉 116 μg/L）. Score of PANSS at the end of the 3rd week in low and moderate concentration group was higher than that in high concentration group, but the difference did not fulfill the level of significance （ P 〉 0.05 ）. Conclusion The clinical efficacy of aripiprazole for schizophrenia is not correlated with its plasma concentration.