帕利哌酮缓释片治疗精神分裂症患者的血药浓度与临床疗效

目的 探讨帕利哌酮缓释片治疗精神分裂症患者的血药浓度与临床疗效的相关性。方法 选择2014年9月—2017年8月在新乡医学院第二附属医院诊治的101例精神分裂症患者，给予帕利哌酮缓释片治疗，在治疗第2、4、8周进行帕利哌酮血药浓度检测，同时进行临床疗效、不良反应的判定与记录。结果 101例患者的帕利哌酮缓释片平均口服剂量为（6.30±0.98）mg/d，平均血药浓度为（31.90±14.29）ng/mL，治疗第2、4、8周的服药剂量与血药浓度对比无显著差异。治疗第2、4、8周的有效率分别为82.2%、92.1%、98.0%，对比差异显著（P<0.05）。治疗第2、4、8周的不良反应发生率分别为8.9%、9.9%、10.9%，对比无显著差异。Spearman非参数相关分析显示帕利哌酮的血药浓度与临床疗效有效率间无显著相关性（r=0.154）；治疗第8周，发生不良反应的患者血药浓度明显高于未发生不良反应（P<0.05）。结论 帕利哌酮缓释片治疗精神分裂症有很好的治疗效果，随着帕利哌酮缓释血药浓度的增加，临床疗效无显著增加，但是可增加不良反应发生率，需要合理调整用药剂量。

The plasma concentration and clinical efficacy of paliperidone sustained tablet in the treatment of schizophrenic patients

Objective To explore the correlation between the plasma concentration and clinical efficacy of paliperidone sustained tablet in the treatment of schizophrenic patients. Methods The study time was from September 2014 to August 2017, 101 schizophrenic patients in our hospital diagnosis and treatment were selected as the research object, All patients were given the treatment of paliperidone sustained tablet, the plasma concentration were detected after treatment of 2 weeks, 4 weeks and 8 weeks, and were to determination and record the clinical efficacy and adverse reaction. Results The average oral dose of paliperidone sustained tablet in 101 patients was (6.30 ±0.98) mg/d, and the average plasma concentration was (31.90 ±14.29) ng/mL. There were no significant difference in the dosage between 2 weeks, 4 weeks and 8 weeks after treatment. The rates of treatment for 2 weeks, 4 weeks, and 8 weeks were 82.2%, 92.1% and 98%, respectively, and compared the difference were significantly (P < 0.05). The incidence of adverse reactions for 2 weeks, 4 weeks and 8 weeks were 8.9%, 9.9% and 10.9%, respectively, and compared were not significant difference (P < 0.05). Spearman nonparametric correlation analysis showed that there was no significant correlation between the plasma concentration of paliperidone and the effective rate (r=0.154, P > 0.05). The plasma concentration of paliperidone sustained tablet in patients who had adverse reactions after 8 weeks of treatment was significantly higher than those without adverse reactions (P < 0.05). Conclusions The paliperidone sustained tablet has a good clinical efficacy in the treatment of schizophrenia. With the increase of plasma concentration of paliperidone sustained tablet, there is no significant increase in the clinical efficacy, but it can increase the incidence of adverse reactions, so we need to adjust the dosage rationally.