利培酮、氯氮平的血药浓度与精神分裂症患者心肌酶的相关性

Correlations of serum concentration of risperidone and clozapine with myocardial enzymogram in patients with schizophrenia

目的了解抗精神病药物利培酮、氯氮平的血药浓度对精神分裂症患者心肌酶的影响。方法以心肌酶CK-MB正常的精神分裂症患者为研究对象,分为利培酮组和氯氮平组,于治疗第2、4、8周末监测患者血药浓度及心肌酶,包括肌酸激酶(CK)、肌酸激酶同工酶MB亚型(CK-MB)和天门冬氨酸氨基转移酶(AST)。结果①与治疗前相比较,利培酮组和氯氮平组在第2、4、8周末CK、CK-MB、AST的升高有统计学差异(P<0.01),但利培酮组第4周末与第8周末相比较无明显差异(P>0.05);②利培酮血药浓度与CK-MB呈正相关(r>0.50,P<0.05);③氯氮平血药浓度与CK、CK-MB、AST呈正相关(r>0.50,P<0.05)。结论利培酮和氯氮平在用药早期可引起心肌酶的升高,氯氮平血药浓度与心肌酶呈正相关,利培酮血药浓度与CK-MB呈正相关。

Objective To explore the effects of serum concentration of risperidone and clozapine on the myocardial en zymogram indexes （including CK,CKMB and AST） in schizophrenic patients. Methods The serum CKMB levels were tested at pretreatment and patients in normal level were recruited in this study, treated with risperidone or clozapine respective ly. The serum concentration of risperidone and clozapine as well as serum levels of CK,CKMB and AST were tested at base line, the end of 2nd, 4th and 8th weeks of treatment. Results （1）The serum levels of CK,CKMB and AST were significantly increased （P〈0.01） in the end of 2nd,4th, 8th week treatment compared with pretreatment, but that increased trend disappeared at the end of 4th week treatment, thus no significance was found between the 4th and 8th week treatment in risperidone （P〉 0.05 ）. （2）Significant positive correlations were found between the serum concentration of risperidone and serum level of CKMB （r〉0.50, P〈0.05）, and between the serum concentration of clozapine and serum levels of CK,CKMB and AST （r〉0.50, P〈 0.05）. Conclusion During the early treatment of risperidone and clozapine, the serum myocardial enzymogram levels signifi cantly increase and are parallel with the serum concentration of clozapine, while the serum concentration of risperidone is posi tively correlated with CKMB level.