氟西汀治疗抑郁症时的血药浓度监测及其临床应用分析

Monitoring of the serum concentration of fluoxetine for depression and analysis of its clinical application

目的 :探讨血药浓度监测在氟西汀治疗抑郁症中的临床应用价值。方法 :收集我院心理科2013年1-12月使用氟西汀治疗的58例抑郁症患者的病例资料,按是否予于血药浓度监测分为观察组(n=32)和对照组(n=26)。血药浓度于口服氟西汀6 h后采用高效液相色谱仪检测。比较两组患者治疗前和治疗1、2、4、8周后的《汉密尔顿抑郁量表》和《不良反应量表》评分。结果 :治疗1、2、4和8周后,观察组患者的《汉密尔顿抑郁量表》和《不良反应量表》评分均显著低于同期的对照组患者(P均<0.05),但两组患者在治疗8周后的总有效率相当,分别为87.5%和84.6%,差异比较无统计学意义。结论 :根据氟西汀血药浓度监测结果制定个体化给药方案有利于提高患者预后并减少不良反应的发生。

Objective： To study the clinical application and the serum concentration monitoring of fluoxerine for depression. Methods： The clinical data of 58 cases of patients with depression, who were treated in 2013 at the psychology department of our hospital, were divided into an observation group （n=32） and a control group （n=26）. The serum concentrations of fluoxetine in the observation group were monitored by HPLC 6 hours after taking fluoxetine. The Hamilton Depression Scale （HAMD） and Treatment Emergent Symptom Scale （TESS） of patients were compared between two groups before treatment and hereafter l, 2, 4, 8 weeks. Results： The HAMD and TESS scores were significantly lower in the observation group than in the control group during that period （P〈0.05）. However, the total efficiency in two groups was almost equal after eight weeks treatment, which was 87.5% in the observation group and 84.6% in the control group, the difference was not statistically significant. Conclusion： It＇s important to formulate individualized dosing regimen based on the results of serum concentration monitoring of fluoxetine in order to improve the prognosis of patients and reduce the incidence of adverse reaction.