氯氮平治疗精神分裂症的剂量、血药浓度和临床效应的性别差异

目的研究氯氮平治疗精神分裂症的剂量、血药浓度和临床效应的性别差异。方法采用高剂量氯氟平（500mg／d）治疗男女性患者各48例与34例，低剂量氯氮平（200mg／d）治疗男女性患者各45例与49例。疗效和不良反应分别用简明精神病量表和不良反应量表评定，并测定治疗第1、2、4、6周的稳态血药浓度。结果氯氮平同等剂量时疗效无性别差异，但女性的血药浓度显著高于男性，女性的不良反应显著重于男性。而且女性患者在剂量不同时血药浓度和不良反应也有明显不同。结论女性精神分裂症患者接受氯氮平治疗以低剂量（200mg／d）适宜。

Gender differences in dosage,serum concentration and clinical response of clozapine in treating schizophrenia

To investigate the gender differences indose, serum concentration and clinical response of clozapinein treating schizophrenic patients. Methods 48 maleand 34 female patientS were beated by high dose of clozapine.45 male and 49 female were treated by low dose of clozapinefor six weeks. T'herapeutic efficacy was measured by BPRSand adverse reaction was identified by TESS, steady serumdrug concentration was monitored in the lst, Znd, 4th, andsixth week after the treatment. Results T'he serumclozapine concentration in the female patients was significantlyhigher than the male patientS with same dose. No differencewas found in efficacy betWeen male and female. T'he femalehad more seriously side effectS than male. The significant differences of serum clozapine level and side effect were found inthe female beated with different dose of clozapine. clusions The female patients need less dose of clozapinecompared with the male, and the optimal dose of clozapine forthe female is 200mg/d.