3种常见抗精神分裂药物的血药浓度分析

Analysis on blood concentration of three common antipsychotic drugs

目的:观察3种常用抗精神分裂药物(利培酮、奥氮平、喹硫平)给药后的血药浓度情况,探讨血药浓度的影响因素和浓度/剂量(C/D)比值在不同人群中的差异,为药物的个体化治疗提供参考。方法:采用回顾性研究方法,分析本中心在2019年6月–2020年2月期间住院的712例精神分裂症患者的血药浓度监测数据,参照相关指南推荐的标准确定血药浓度参考范围,并计算浓度/剂量(C/D)比值。结果:给予利培酮、奥氮平和喹硫平治疗的患者处在参考浓度范围内的比例分别为70.0%,70.6%和68.6%;低剂量水平的C/D比值显著高于高剂量水平;女性患者C/D比值高于男性;60岁以上患者C/D比值高于年轻患者。结论:本中心三种药物的临床给药剂量基本合理,女性和老年患者建议适当减少给药剂量以避免不良反应的发生。

Objective:To investigate the blood concentration of three common antipsychotic drugs(risperidone,olanzapine,quetiapine)after administration,explore the influence factors of blood concentration and the difference of concentration/dose(C/D)ratio in different populations,so as to provide references for the individualized medication.Methods:Therapeutic drug monitoring(TDM)data of 712 schizophrenic inpatients in a center from June 2019 to February 2020 were retrospectively analyzed.The reference range of blood concentration of the three antipsychotic drugs was determined according to the related guideline and the C/D ratio was calculated.Results:The proportions of patients treated with risperidone,olanzapine and quetiapine whose blood concentrations of the three drugs were within the reference concentration range were 70.0%,70.6%and 68.6%,respectively.The C/D ratio of low-dose level was significantly higher than that of high-dose level.The C/D ratio of female patients was higher than that of male patients.The C/D ratio of patients over 60 years old was higher than that of patients below 60 years old.Conclusion:The clinical dosage of the three drugs was generally reasonable.Female and elderly patients should reduce the dosage in order to avoid the occurrence of the adverse drug reactions.