氯氮平治疗精神分裂症临床疗效与血浓度研究

目的:探讨氯氮平治疗精神分裂症的临床效应与剂量、血药浓度、的关系。方法:用不同剂量氯氮平治疗精神分裂症64例(A组200mg/日,22例,B组400mg/日,24例;C组600mg/日,18例),用简明精神症状评定量表(BPRS)和临床总体印象量表(CGI)及副反应量表(TESS)评定疗效及副反应,并测定治疗第2、4、8周末晨服药前的稳态血浓度,共观察8周。结果:(1)三组比较总有效率,BPRS总减分率,TESS增分值均有显著差异(P<0.05);(2)氯氮平血浓度与剂量呈正相关;(3)血浓度与结束时BPRS评分之间呈负相关(P<0.05);(4)高剂量组副反应明显大于低剂量组(P<0.05);(5)血浓度与TESS评分之间的关系尚不能确定(P>0.05)。结论:推荐单用氯氮平治疗精神分裂症的稳态血药浓度为400ug/L左右。

A study of the correlations of clinical effects of clozapine for treatment schizophrenia and blood concentration

Objective: To study the correlations oi blood concentration and the clinical effects of different dosages of Clozapine for treatment schizophrenia. Methods: Sixty- four patients with diagnosis of schizophrenia were divided into three groups each of which different dosages of Clozapine was given for treatment (Group A: 22 patients, 200mg/per days; Group B: 24 patients, 400mg/per day; Group C: 18 patients, 600mg/per day). The therapeutic response was evaluated with the BPRS, CGI and TESS. The observation lasted eight weeks during which stable blood concentration was tested before agent was taken on the morning of the 2nd, 4th, and 8th weekends. Results: 1) Between the three groups, there was significant difference in the total efficiency, the total BPRS decreasing rate and the total TESS increasing rate (P<0.05). 2) Blood concentration is direct proportion to dosages. 3) Blood concentration is inversely proportional to the final scores of BPRS. 4) The higher dosages of Clozapine, the stronger negative side effects there are. 5) Correlations between blood concentration and TESS is still unknown (P >0.05). Conclusions: Stable blood concentration around 400u g/1 is recommended for single dose of Clozapine for treatment schizophrenia.