利培酮血药浓度监测在基层医院精神分裂症治疗中的应用研究

Application of therapeutic drug monitoring of risperidone in the treatment of schizophrenia in primary hospitals

目的观察利培酮血药浓度监测在基层医院精神分裂症治疗中的应用效果。方法120例精神分裂症接受利培酮血药浓度监测的患者为研究对象,比较患者治疗后8、43 d的阳性和阴性症状量表(PANSS)评分、副反应量表(TESS)评分及血药浓度,治疗效果。结果患者治疗后43 d的PANSS阴性症状评分(19.67±2.28)分及阳性症状评分(18.52±2.77)分、TESS评分(2.08±0.42)分低于治疗后8 d的(27.85±4.70)、(30.25±4.92)、(2.83±0.35)分,利培酮血药浓度(55.55±5.80)ng/ml高于治疗后8 d的(47.52±4.33)ng/ml,差异具有统计学意义(P<0.05)。患者治疗后43 d的总有效率94.17%高于治疗后8 d的75.83%,差异具有统计学意义(P<0.05)。结论在基层医院精神分裂症治疗中开展利培酮血药浓度监测,可显著的改善患者治疗后43 d的症状评分,提高利培酮血药浓度,减少用药不良反应,提升临床治疗效果,效果理想。

Objective To observe the application effect of therapeutic drug monitoring of risperidone in the treatment of schizophrenia in primary hospitals.Methods 120 patients with schizophrenia receiving therapeutic drug monitoring of risperidone were studied.The Positive and Negative Symptom Scale(PANSS)score,Treatment Emergent Symptom Scale(TESS)score,blood drug concentration and therapeutic effect were compared 8 and 43 d after treatment.Results 43 d after treatment,the PANSS negative symptom score was(19.67±2.28)points,the positive symptom score was(18.52±2.77)points and TESS score was(2.08±0.42)points,which were lower than those of(27.85±4.70),(30.25±4.92)and(2.83±0.35)points 8 d after treatment;the blood drug concentration of risperidone of(55.55±5.80)ng/ml was higher than that of(47.52±4.33)ng/ml 8 d after treatment;the differences were statistically significant(P<0.05).The total effective rate was 94.17%43 d after treatment,which was higher than that of 75.83%8 d after treatment,and the difference was statistically significant(P<0.05).Conclusion In the treatment of schizophrenia in primary hospitals,therapeutic drug monitoring of risperidone can significantly improve the symptom score of patients 43 d after treatment,increase the blood drug concentration of risperidone,reduce the adverse drug reactions,improve the clinical effect,and the effect is ideal.