喹硫平在精神分裂症患者治疗中血药浓度的检测及其对临床效应的影响因素研究

Study on Determination of Blood Concentration of Quetiapine in Patients with Schizophrenia and Its influence on Clinical Efficacy

目的:研究精神病患者服用喹硫平后日常血药浓度的变化及其对临床效应的影响因素,为喹硫平临床合理使用提供参考。方法:抽取2018年1-12月间收治的服用喹硫平治疗的精神病患者786例资料,统计其喹硫平日常血药浓度的检测结果和患者的性别、年龄及服药剂量等因素,分析喹硫平血药浓度与患者性别、年龄及服药剂量之间的关系。结果:患者喹硫平日服用剂量最多的为0~150 mg/d (25.45%),其次为150~300 mg/d (24.43%)、450~600 mg/d (21.76%)以及300~450 mg/d (11.96%),4个剂量所占百分比83.60%;喹硫平血药浓度主要集中在0~150 ng/mL(57.76%),其次为150~300 ng/mL(30.28%),2个血药浓度所占百分比88.04%;平均血药浓度随着患者给药剂量的增加而升高,其浓度剂量比随着患者给药剂量的增加而下降;随着年龄的增长,血药浓度剂量比呈现上升趋势。结论:喹硫平临床日常血药浓度的监测,不仅能够促进药物发挥更好的临床效应,促进了抗精神病药物的合理使用,且同时避免或减少了不良反应的发生。

Objective: To study the change of daily blood drug concentration in patients with mental illness after taking quetiapine and its influencing factors on clinical efficacy, and to provide a reference for the rational use of quetiapine in clinic. Methods: Data of 786 cases of mental patients treated with quetiapine from January to December 2018 were extracted. The results of routine blood concentration test of quetiapine, gender, age and dose of the patients were calculated,and the relationship between blood concentration of quetiapine, gender, age and dose were analyzed. Results: The most common dose of quetiapine was between 0 and 150 mg, everday(25.45%), and then was between 150 and 300 mg,(24.43%), 450 and 600 mg(21.76%), 300 and 450 mg, everday(11.96%), and 4 doses accounted for 83.60% of the total constituent ratio. The plasma concentration of quetiapine was mainly concentrated between 0 and 150 ng/mL(57.76%),and then between 150 and 300 ng/mL(30.28%), and 2 concentrations accounted for 88.04% of the total composition ratio. The average plasma concentrations of the patients were increased with the increase of the dosage, and the concentration-dosage ratios were reduced with the increase of the dosage. With the increase of age, the concentration-dosage ratios showed an increasing trend. Conclusion: The monitoring of the daily blood drug concentration of quetiapine can not only promote the better clinical efficacy of drugs, but also can promote the rational use of antipsychotic drugs, and at the same time can avoid or reduce the occurrence of adverse reactions.