奥氮平治疗精神分裂症血药浓度监测及影响因素分析

Monitoring of plasma concentration of olanzapine in the treatment of schizophrenia and analysis of influencing factors

目的:了解奥氮平治疗精神分裂症患者的血药浓度情况及其影响因素,为临床个体化用药提供参考。方法:收集2022年度山东省精神卫生中心精神分裂症住院患者服用奥氮平治疗进行血药浓度监测的临床资料,采用卡方检验和logistic回归分析年龄、性别、服药剂量、是否首发等因素对患者血药浓度是否达标的影响。结果:纳入分析的539例患者共计监测1593例次血药浓度,其中1250例次(78.47%)血药浓度达标。19~40岁和41~59岁年龄组患者血药浓度达标率分别是≤18岁年龄组患者的1.838倍(P=0.044)和1.946倍(P=0.038)。女性患者血药浓度达标率是男性患者的0.460倍(P<0.000)。服用剂量为5~10mg和10~30mg的患者血药浓度达标率分别是服用剂量≤5mg患者的9.252倍(P<0.001)和11.117倍(P<0.001)。结论:服用剂量对奥氮平血药浓度达标具有正向作用,且存在个体差异,应常规进行奥氮平血药浓度监测,提高精神分裂症治疗的有效性和安全性。

Objective:To investigate the plasma concentration of olanzapine in the treatment of schizophrenia and its influencing factors,and to provide reference for clinical individualized drug use.Methods:Clinical data of in-patients with schizophrenia receiving olanzapine treatment in Shandong Mental Health Center in 2022 were collected.Chi-square test and logistic regression were used to analyze the effects of age,gender,dosage and whether the first dose on the blood concentration of patients.Results:A total of 1593 blood drug concentrations were monitored in 539 patients included in the analysis,of which 1250(78.47%)blood drug concentrations reached the standard.The rate of compliance of blood drug concentration in 19~40 and 41~59 age groups was 1.838 times(P=0.044)and 1.946 times(P=0.038),respectively,compared with that in≤18 age group.The rate of conforming blood concentration in female patients was 0.460 times higher than that in male patients(P<0.000).The rate of compliance of blood concentrations in patients taking doses 5~10 mg and 10~30 mg was 9.252 times(P<0.001)and 11.117 times(P<0.001),respectively,compared with patients taking doses≤5 mg.Conclusion:The dose of olanzapine has a positive effect on the blood concentration reaching the standard,and there are individual differences.Olanzapine blood concentration monitoring should be performed regularly to improve the effectiveness and safety of the treatment of schizophrenia.