丙戊酸钠联合奥氮平在青少年双相情感障碍治疗中血药浓度与效果分析

Analysis of Serum Concentration and Therapeutic Effect of Valproate Combined with Olanzapine in the Treatment of Adolescent Bipolar Disorder

目的:分析丙戊酸钠联合奥氮平在青少年双相情感障碍治疗中血药浓度与效果。方法:选取2020年1-4月本院收治的双相情感障碍的青少年患者35例,所有患者均给予丙戊酸钠联合奥氮平治疗。治疗15 d后检测血药浓度,并进行剂量调整,治疗30 d后,再次检查血药浓度。比较治疗15、30 d后35例患者丙戊酸钠与奥氮平的使用剂量与血药浓度。比较治疗15、30 d后的Bech-Rafaelsen躁狂量表(BRMS)与汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分。观察35例患者的治疗效果及药物副反应情况。结果:治疗30 d后,丙戊酸钠每天使用剂量与血药浓度均高于治疗15 d后(P<0.05)。治疗15 d后奥氮平每天使用剂量与治疗30 d后比较,差异均无统计学意义(P>0.05),治疗30 d后奥氮平血药浓度高于治疗15 d后(P<0.05)。治疗15、30 d后,BRMS与HAMD评分均逐渐降低,差异均有统计学意义(P<0.05)。35例患者治疗总有效率为100%,治疗副反应量表(TESS)评分为(1.23±0.06)分。结论:青少年双相情感障碍治疗时根据血药浓度调整丙戊酸钠与奥氮平剂量疗效显著,保证最小剂量即可达到有效血药浓度,降低药物副反应。

Objective:To analyze the serum concentration and effect of Valproate combined with Olanzapine in the treatment of adolescents with bipolar disorder.Method:A total of 35 adolescent patients with bipolar disorder admitted to our hospital from January to April in 2020 were selected,all patients were treated with Valproate combined with Olanzapine.Serum concentration was detected and the dose was adjusted after 15 d of treatment,and serum concentration was detected again after 30 d of treatment.The dosage and serum concentration of Valproate and Olanzapine in 35 patients were compared after 15 and 30 d treatment.The Bech-Rafaelsen manic scale(BRMS)and Hamilton depression scale(HAMD)scores were compared after 15 and 30 d of treatment.The therapeutic effect and side effects of drugs were observed in 35 patients.Result:After 30 d of treatment,the daily dose and serum concentration of Valproate were higher than those after 15 d of treatment(P<0.05).There were no statistically significant differences in the daily dose of Olanzapine after 15 d and 30 d of treatment(P>0.05),and the serum concentration of Olanzapine after 30 d of treatment was higher than that after 15 d of treatment(P<0.05).After 15 and 30 d of treatment,the BRMS and HAMD scores decreased gradually,with statistical significance(P<0.05).The total effective rate of 35 patients was 100%,and treatment side effects scale(TESS)score was(1.23±0.06)scores.Conclusion:In the treatment of adolescent bipolar disorder,adjusting the dosage of Valproate and Olanzapine according to the serum concentration has significant curative effect,ensuring the minimum dose can reach the effective serum concentration and reduce the drug side effects.