奥氮平和丙戊酸钠治疗急性躁狂发作的短期疗效与血药浓度分析

目的探讨奥氮平与丙戊酸钠治疗急性躁狂发作的短期疗效及血药浓度的相互影响。方法将44例躁狂发作患者,随机均分为奥氮平组和丙戊酸钠组,治疗第8天时改为同剂量联合治疗1周。分别测定1周和2周时血药浓度,以YMRS减分率和TESS评定临床疗效和不良反应。结果奥氮平组治疗2周末显效率显著高于丙戊酸钠组(P<0.05);YMRS评分第1周相对基线均有明显下降,奥氮平组下降更明显(P<0.05);奥氮平显效浓度显著高于非显效患者的血浓度(P<0.05)。结论奥氮平单一或联合丙戊酸钠治疗急性躁狂发作均有较好疗效,起效快,安全性高和耐受性良好。血药浓度监测具有重要的临床意义。

Short-Term Efficacy and Serum Concentrations Alterations of Olanzapine and Valproate in Treatment of Acute Manic

Objective To evaluate the short-term efficacy and serum concentrations alterations of olanzapine and divalproex in the treatment of acute mania episodes. Methods 44 patients with acute mania episodes were randomly divided into the olanzapine group and the divalproex group equally, treated with single medicine and combined medicine. The serum concentrations of olanzapine and divalproex were measured, and the efficacy and safety were evaluated by YMRS and TESS respectively. Results After 2 weeks of treatment, the marked progress ratio of olanzapine group was significantly higher than that of divalproex groups （P〈0.05）. The YMRS score at 1 week of therapy decreased in both group, but the olanzapine group decreased more significantly （P 〈0.05）. The markedly concentration of olanzapine was significantly higher than those patients without marked progress （P 〈0.05）. Conclusions Both monotherapy and combination therapy with divalproex and olanzapine have efficacy, rapid onset, safe and well-tolerated. The monitoring of serum concentration has important significance.