喹硫平治疗精神疾病的血药浓度探讨

Study on the Blood Concentration of Quetiapine in the Treatment of Mental Disorders

目的通过研究我院精神科治疗药物血药浓度的特点并分析,探索精神科治疗药物喹硫平血药浓度的影响因素以指导临床用药,从而在临床治疗过程中,患者可在最低不良反应发生率的情况下得到最佳的治疗效果。方法采用高效液相色谱仪建立检测喹硫平血药浓度的方法,获得患者喹硫平血药浓度数值,收集符合条件的患者的病例,记录相关信息,运用分析软件进行数据处理,分析药物血药浓度与药物疗效、剂量、合并用药是否存在联系,得出一个能达到最佳疗效和较小的不良反应发生率的血药浓度范围、警戒值。结果喹硫平血药浓度与剂量呈正相关,但与疗效是非线性关系,血药浓度在一定范围内是有效的。合并用药对疗效无太大影响,但需要结合临床实际用药情况观察患者不良反应,推荐喹硫平使用单一用药。在100-500 ng/mL血药浓度范围内其治疗有效率高,不良反应率较低。当达到1000 ng/mL时药物疗效较低,且不良反应发生率较高,故将1000 ng/mL定为警戒值。结论喹硫平推荐治疗药物浓度监测的参考范围100-500 ng/mL,警戒值为1000 ng/mL。

Objective By studying and analyzing the characteristics of the psychiatric drug concentration in our hospital,the influencing factors of the psychiatric drug quetiapine plasma concentration was explored to guide clinical medication,so that in the clinical treatment process,the best treatment effect of patients was obtained under the condition of the incidence at the lowest adverse reactions.Methods High-performance liquid chromatography was used to establish a method for detecting quetiapine blood concentration,obtain the value of quetiapine blood concentration in patients,collect the cases of eligible patients,record relevant information,use analysis software for data processing,and analyze that whether there was a relationship between blood drug concentration and drug efficacy,dose,and concomitant medication,a blood drug concentration range and alert value could be obtained that can achieve the best curative effect and less incidence of adverse reactions.Results The plasma concentration of quetiapine was positively correlated with the dose.However,but non-linearly with the efficacy of the drug,and the plasma concentration was effective within a certain range.Combination medication did not have much effect on the curative effect,but it was necessary to observe the adverse reactions of patients in combination with the actual clinical medication situation,and it was recommended to use a single medication of quetiapine,and the therapeutic effect was high in the range of 100-500 ng/mL plasma concentration,and the adverse reaction rate was lower.When it reaches 1000 ng/mL,the efficacy of the drug was lower,and the incidence of adverse reactions was high,so 1000 ng/mL was set as the warning value.Conclusion Quetiapine recommended reference range for monitoring the concentration of therapeutic drug was 100-500 ng/mL,and the alert value was 1000 ng/mL.