奥氮平治疗精神病的疗效，副反应与血药浓度的关系

目的:分析奥氮平治疗精神病的疗效,副反应与血药浓度的关系.方法:用高效液相法测定病人的血药浓度,用阳性及阴性症状量表(PANSS),简明精神病评定量表(BPRS),社会功能缺陷筛选量表(SDSS)及副反应量表(TESS)评定其疗效和副作用.结果:奥氮平能显著降低阳性及阴性症状评价,且副反应轻微,剂量相同时,奥氮平血药浓度的个体差异较大,85%的病人的血药浓度在25-160nmol/L之间,其有效率为81.8%,浓度剂量的比值(C/D)与疗效呈正相关,结论:奥氮平能有效的治疗精神病,并改善社会功能障碍,25nmol/L是奥氮平适宜血药浓度的低限.奥氮平C/D值高的病人疗效好.

The relationship between olanzapine serum concentrations and its efficacy or side effects for the treatment of psychosis.

Objective To analysis the relationship between olanzapine serum levels and its efficacy or side effects for the treatment of psychotic patients.Methods 26 patients who met CCMD-2-R criteria for schizophrenia,schizophreniform disorder,schizoaffective disorder,or paranoiac psychosis entered the 8-week study.Olanzapine in serum was determined by HPLC using ultraviolet detection.Efficacy of olanzapine was evaluated by positive and negative symptoms scale(PANSS),the brief psychiatric rating scale(BPRS),and social disabilities screening scale(SDSS).Side effects was assessed by treatment emergent symptom scale(TESS).Results Olanzapine demonstrated great efficacy in positive and negative symptoms of psychosis.The interindividual difference of olanzapine serum concentrations was large when their dose was equal.85 percent patients' olanzapine serum levels were between 25nmol/L and 160nmol/L,and in which the response rate of the patients was 81.8 percent.The efficacy of olanzapine was related to the concentrationtodose ratio(C/D)positively.Conclusions Olanzapine has great efficacy for the treatment of psychosis.The lowest appropriate serum concentration of olanzapine is 25nmol/L.The patients with high C/D ratio will gain better effects.