阿立哌唑治疗急性期精神分裂症的血药浓度与剂量及疗效的相关性

The correlation between aripiprazole plasma concentration and dose or efficacy in the therapy of acute schizophrenia

目的探讨阿立哌唑治疗急性期精神分裂症的疗效、安全性及耐受性,及其血药浓度与剂量、疗效的相关性。方法 36例精神分裂症患者服用阿立哌唑,分期对其进行阳性与阴性症状量表评定,记录血压、体重、腹围、体质指数,检测总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、空腹血糖、催乳素及阿立哌唑血药浓度。结果治疗有效率为72.22%,因疗效不佳的脱落率为8.33%;不良反应发生率为27.78%;没有因不良事件退出研究;治疗4周末及6周末的药物剂量与血药浓度呈中度相关,但与减分率之间无显著相关性。结论阿立哌唑对急性期精神分裂症治疗有效,耐受性好;阿立哌唑可能引起三酰甘油升高,不会导致催乳素上升,对其他糖脂代谢指标及心电图QTc间期可能没有影响;其血药浓度可能与治疗6周末的药物剂量和疗效相关。

Objective To investigate the efficacy,safety and tolerability of aripiprazole in treatment of acute schizophrenia,and the correlation between its plasma concentration and dose or efficacy.Methods The Positive and Negative Syndrome Scale（PANSS）,blood pressure,weight,circumference,body mass index,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,fast plasma glucose,prolactin and plasma concentration of aripiprazole were assessed in 36 patients with schizophrenia.Results The total efficacy of aripiprazole was 72.22%,with premature withdrawal due to bad efficacy of 8.33%.Ten adverse events（27.78%） were reported,while there was no withdrawal due to adverse effects.The plasma concentration and dose of aripiprazole were significantly correlated at the end of 4th and 6th week（P 0.01）,however,there was no significantly correlation between PANSS alleviation and oral-dose of aripiprazole.Conclusion Aripiprazole is effective with good tolerability in treatment of schizophrenia.It increases triglyceride,reduces prolactin,and has no impact on the other index of metabolism or QTc interval.Plasma concentration of aripiprazole is correlated with the dose and efficacy after 6 weeks of therapy.