氯氮平及其代谢物在人血液中的药代动力学研究

Study on the pharmacokinetics of clozapine and its metabolites in human blood

目的研究氯氮平及其代谢物在人血液中的药代动力学和检出时限,为氯氮平中毒的法医学鉴定提供实验依据。方法 29名太原汉族人口服12.5mg氯氮平后不同时间采集肘静脉血,固相萃取法提取,超高效液相色谱-串联质谱仪分析,MRM(多反应离子检测)记录方式,保留时间和定性离子对定性,内标法和标准曲线法定量检测其中氯氮平、去甲氯氮平、氮氧氯氮平含量,3p97药代动力学软件拟合C-T数据,计算药代动力学参数。结果口服12.5mg氯氮平后,氯氮平、去甲氯氮平、氮氧氯氮平在血中动力学过程均符合一级吸收二室开放模型,达峰时间分别为2.96±1.32h、8.65±3.00h、9.31±26.38h,达峰浓度分别为34.68±9.32ng/mL、11.16±4.15ng/mL、9.62±13.88ng/mL,半衰期分别为17.02±23.63h、27.06±12.58h、41.27±29.75h,血中检出时限分别为81.72±26.19h、93.21±29.40、19.93±14.62h。结论口服氯氮平后氯氮平及其代谢物去甲氯氮平、氮氧氯氮平的药物动力学符合一级吸收二室开放模型,模型和参数可以为氯氮平的法医学鉴定提供实验依据。

Objective To study the pharmacokinetics and detection window of clozapine and its metabolites in human blood, so as to provide experimental basis for forensic cases of identification of clozapine poisoning. Methods 29 Taiyuan Han people＇s elbow venous blood was collected after given oral administration of 12.5mg clozapine at different time point, in which clozapine and its metabolites were extracted with solid phase extraction（SPE） and determined by HPLC-MS-MS. The qualitative analysis was based on retention time and MRM ions. The quantitative analysis was based on an internal standard method and calibration curve. Using the 3p97 pharmacokinetic software, pharmacokinetic equation of clozapine in the blood were imitated from the C-T data, and pharmacokinetic parameters were calculated. Results The pharmacokinetics of clozapine met a two compartment open model with a first kinetics absorption. The T_（max） of clozapine（CLP）, demethylclozapine（DMCLP）, N-oxidation-clozapine（NO-CLP） respectively were 2.96±1.32 h, 8.65±3.00 h, 9.31±26.38h; The C_（max） of CLP, DMCLP, NO-CLP respectively were 34.68±9.32ng/mL, 11.16±4.15ng/mL, 9.62±13.88ng/mL; The t1/2 of CLP, DMCLP, NO-CLP respectively were 17.02±23.63 h, 27.06±12.58 h, 41.27±29.75h; The detection window of CLP, DMCLP, NO-CLP respectively were 81.72±26.19 h, 93.21±29.40 h and 19.93±14.62 h. Conclusion The pharmacokinetics of clozapine in blood of Han people is consistent with two compartment open model with a first kinetics absorption. The pharmacokinetics model and parameters of clozapine can provide expirimental basis for forensic identification of clozapine poisoning cases.