再普乐对氯氮平血药浓度及治疗精神分裂症疗效的影响

THE INFLUENCING OF OLANZAPINE TO THE BLOOD DRUG LEVEL OF CLOZAPINE AND THE TREATMENT EFFECT OF SCHIZOPHRENIA

[目的]探讨再普乐对氯氮平血药浓度及疗效的影响。[方法]将50例长期服用氯氮平(1年以上)治疗的精神分裂症患者随机分为两组,对照组26例,延用氯氮平200～500mg/d治疗;治疗组24例,在用氯氮平200～500mg/d的同时,加用再普乐5～15mg/d,治疗12周,以阳性症状与阴性症状量表(PANSS)评定疗效,用高效液相色普法(HPLC)测定氯氮平稳态血药浓度。[结果]两组在12周末氯氮平血药浓度差异无统计学意义(P﹥0.05),各组治疗前后PANSS总分均显著下降(P﹤0.05〉,两组同期的PANSS总分下降差异无统计学意义(P﹥0.05),阳性症状评分差异无统计学意义(P﹥0.05)。阴性症状评分治疗组较对照组有改善,差异有统计学意义(P﹤0.05〉。[结论]合用再普乐并不影响氯氮平的血药浓度及疗效,一定程度上还可改善精神分裂症的阴性症状。

[Objective] To explore the enfulencing of olanzapine to the blood drug level of clozapine and treatment effect of schizophrenia. [ Methods] 50 schizophrenia patients with long term taking clozapine for more than one year were randomly divided into two groups, 26 patients were recruited as controls who treated with elozapine at the dose of 200 to 500 mg per day, while 24 patients in experiment group were treated with clozapine at the dose of 200 to 500 mg per day and olanzapine at the dose of 5 to 15 mg per day for 12 weeks. The therapeutic effect was evaluated with positive symptoms and measuring scale of positive symptoms, and the steady plasma-drug concentration of clozapine was deterufined with HPLC. [ Results] The blood drug level of elozapine at the time of 12 weekend did not showed significantly difference in the two group （P 〈 0.05 ）. The total scale of PANSS showed significant decreased before and .after treatment in the two groups （P 〈 0.05）, while the total scale of PANSS at the same time did not revealed significantly decreased, the scale of positive symptoms did not found significant difference as well （P 〉 0.05）. When compared with control group, the some of positive symptoms among the experiment group did not significantly improved （P 〈 0.05 ）. [ Gonclusion ] Schizophrenia patients treated with combination of olanzapine and clozapinc did not influence the blood drug level and therapeutic effect of clozapine for schizophrenia, which could improve the positive symptoms of schizophrenia to some extence.