小剂量丙戊酸钠对利培酮疗效及血药浓度的影响

Effect of small dose of sodium valproate on the efficacy of risperidone and plasma concentration

目的观察小剂量丙戊酸钠对利培酮疗效、不良反应及血药浓度的影响。方法将55例精神分裂症患者随机分为对照组(利培酮组)30例和研究组(利培酮+丙戊酸钠组)25例。对照组单纯使用利培酮治疗,限定治疗剂量为4mg;研究组同时联合丙戊酸钠片(400～600mg/d)。分别于治疗前与治疗2周末、治疗4周末采用阳性与阴性症状量表(PANSS)评定疗效,采用不良反应量表(TESS)评定治疗中不良反应。于治疗2周末、4周末测定利培酮血药浓度。结果 2组利培酮血药浓度测定结果在治疗2周末、4周末比较差异无统计学意义(P>0.05)。PANSS评分结果显示:在治疗2周末,研究组与对照组相比,差异有统计学意义(P=0.015),而4周末的差异无统计学意义(P=0.740)。2组TESS评分结果比较差异无统计学意义。结论联用小剂量丙戊酸钠不会增加利培酮血药浓度,疗效与血药浓度无明显相关,其不良反应未受影响。

Objective To observe the effect of small dose of sodium valproate on the efficacy of risperidone,side effects and plasma concentration.Methods Fifty-five schizophrenia patients were randomly divided into control group（30 cases） and study group（25 cases）.Control group were treated only with risperidone（4 mg）,in addition,study group were given sodium valproate（400~600 mg/d）.Clinical efficacies were assessed by positive and negative syndrome scale（PANSS）,side effects were assessed by treatment emergent symptom scale（TESS） before the treatment and at the 2nd,4th weekend of the treatment.The blood concentration of risperidone was measured at the 2nd,4th weekend after the treatment.Results There were no significant differences of the blood concentration of risperidone between the two groups at the 2nd,4th weekend after the treatment（P0.05）.The PANSS showed that there were differences between the two groups at the second weekend（P=0.015）,however,there were no differences at the fourth weekend（P=0.740）.The scores of TESS between the two groups had no statistical difference.Conclusion The treatment of small dose sodium vedproate combined with risperidone can get efficacy earlier,and can＇t increase the blood concentration of risperidone.The efficacy is unrelated with plasma concentration,the side-effect may be unaffected.