不同剂量氯氮平的血药浓度与临床效应的关系

Relationship between plasma concentration and clinical effects of clozapine

目的 探讨氯氮平血药浓度与临床效应的关系。方法 65例精神分裂症患者单用氯氮平治疗。用LC-6A型液相色谱仪测定氯氮平血药浓度，用BPRS和TESS量表评定疗效和副反应。结果 氯氮平血药浓度〈200ng／ml时疗效欠佳，在200-600ng／ml范围内时疗效最好。氯氮平血药浓度〈400ng／ml时与副反应发生率相关性差。但随着血药浓度层次的升高，副反应发生率也升高。结论 氯氮平血药浓度以200-500ng／ml作为治疗窗较为合适。

Objective To study the relationship between plasma level and clinical effects of clozapine. Methods Sixty-five schizophrenic inpatients only treated with clozapine were tested with LC-6A typical liquid chromatograph. The clinical effects and side effects were evaluated with BPRS and TESS. Results The clinical effects was poor when the plasma concentration was less than 〈200ng/ml,and was between when the plasma concentration was between 200 and 600ng/ml. The plasma level of clozapine was not related to the rate of side effects when the coneertration was below 400ng/ml,but the higher plasma level was,the higher occurence rate of side effects was. Conclusion The suitable therapeutic window for patients treated with clozapine was 200-500ng/ml.