精神分裂症患者血脂水平对奥氮平血浆药物浓度的影响

Influence of blood lipid levels on olanzapine plasma concentrations in schizophrenic patients

目的探讨精神分裂症患者血脂水平与奥氮平血浆浓度之间的关系。方法根据2007年中国成人血脂防治指南推荐标准,将104例服用奥氮平治疗的符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的精神分裂症患者分为高脂血症组(n=29)和血脂正常组(n=75)。测定患者甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、肾功能(肌酐、尿素)、肝功能(白蛋白、谷丙转氨酶(ALT)、谷草转氨酶(AST)及奥氮平血浆浓度。结果两组患者性别构成、年龄、肾功能(尿素、肌酐)、肝功能(白蛋白、ALT、AST)等指标差异均无统计学意义(P>0.05)。两组患者服用奥氮平剂量差异无统计学意义(P>0.05),但高脂血症组血浆奥氮平浓度低于血脂正常组药物浓度(P<0.05)。多重线性回归分析显示甘油三酯(TG)是影响奥氮平血浆浓度的独立因素,回归系数为负(P<0.05)。结论精神分裂症患者高甘油三酯水平有可能降低奥氮平血浆浓度。

Objective To investigate the relationship between blood lipid levels and plasm concentrations of olanzapine in schizophrenic patients. Methods A total of 104 schizophrenic patients treated with olanzapine were divided into hyperlipidemic group( n= 29) and normolipidemic group( n = 75),according to the diagnosetic criterion of the Prevention and Therapy Guidlines about Chinese Adults Dyslipdidemia published in 2007. Triglyceride( TG),total cholesterol( TC),high- density lipoprotein cholesterol( HDL- C),low- density lipoprotein cholesterol( LDL- C),renal function( creatinine,urea),hepatic function( albumin,alanine transaminase( ALT),aspartate transaminase( AST) and olanzapine plasma concentrations were messured. Results There was no significant difference in gender,age,urea,renal function( creatinine,albumin),hepatic function( ALT,AST) between two groups( P >0. 05). There was no significant difference in olanzapine doses between two groups( P > 0. 05),but the olanzapine plasma concentrations of hyperlipidemic group was significant lower than that of normolipidemic group( P < 0. 05). Multiple linear regression analysis showed that triglyceride( TG) was a independent factor influencing the olanzapine plasma concentrations,regression coefficient was negative( P <0. 05). Conclusion Hypertriglyceride probably decreased olanzapine plasma concentrations in schizophrenic patients.