二甲双胍对氯氮平血药浓度及疗效的影响

目的探索二甲双胍对氯氮平血药浓度及疗效的影响。方法对精神分裂症合并糖尿病,单一服用氯氮平治疗的64例患者,随机分为两组,对照组32例延用氯氮平治疗(200～500mg/日),研究组32例在延用氯氮平(剂量不变)的同时,合用二甲双胍(0.5～1.0g/日)治疗,治疗12周,以阳性症状与阴性症状量表(PANSS)评定疗效,用高效液相色普法(HPLC)测定氯氮平稳态血药浓度。结果合用二甲双胍治疗组(研究组),在合用前、第8周末、12周末,与对照组比较,氯氮平血药浓度差异无统计学意义(P﹥0.05),合用二甲双胍治疗12周后PANSS总分均显著下降,差异有统计学意义(t值=3.37,P﹤0.05),阳性症状评分下降,差异有统计学意义(P﹤0.05);阴性症状评分下降,差异有统计学意义(P﹤0.05)。结论二甲双胍合用氯氮平治疗精神分裂症合并糖尿病患者时,不影响氯氮平的血药浓度及疗效。

Effects of metformin on plasma clozapine concentration and its therapeutic effect

OBJECTIVE To explore the effect of metformin on plasma clozapine concentration and its therapeutic effect. METHODS Of schizophrenia with diabetes,a single clozapine treatment of 64 patients were randomly divided into two groups,control group 32 cases of extended treatment with clozapine(200-500 mg/day),study with 32 patients in the extension Clozapine(dose unchanged)for the same time,plus metformin(0.5-1.0g/day)treatment for 12 weeks,the positive symptoms and negative syndrome scale(PANSS)efficacy was assessed by using the Franco-Prussian high performance liquid chromatography(HPLC). We determined steady-state plasma concentrations of clozapine. RESULTS In the metformin treatment group(study group)before the 8th week,12 weeks,There was no significant difference in the plasma concentration of clozapine compared with the control group(P﹥0.05). The PANSS score was significantly decreased after 12 weeks in metformin treatment group(t = 3.37,P﹤0.05). The positive symptom score decreased,and there was significant difference(P﹤0.05);The negative symptom score decreased,and there was significant difference(P﹤0.05). CONCLUSION Metformin combined with clozapine in treatment of schizophrenia patients with diabetes mellitus could not affect clozapine plasma concentration and effect.