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联合用药精神障碍患者氯氮平血药浓度监测
Detection of plasma clozapine concentration in psychosis disorder inpatients receiving comedications

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蒋平 1   刘红梅 1   任娟娟 1   李婷 2   林治光 1   金一 3   崔慧茹 1   孙秀佳 1   李春波 1 *  
文摘 目的考察联合用药对精神障碍患者氯氮平(CLZ)血药浓度的影响。方法应用高效液相色谱法(HPLC)测定571例服用CLZ的住院精神障碍患者CLZ及去甲氯氮平(N-CLZ)的血药浓度;并结合CLZ剂量、联合用药(氯硝西泮等12种药物)等情况,运用SPSS 17.0软件包分析联合用药对CLZ血药浓度的影响。结果联合用药组CLZ剂量、CLZ血药浓度、N-CLZ血药浓度均低于CLZ单用组, 差异有统计学意义(P<0.01)。其中联用氯硝西泮、帕罗西汀、文拉法新、阿立哌唑、喹硫平和利培酮组的CLZ使用剂量低于CLZ单用组,差异有统计学意义(P<0.05,P<0.01);联用氯硝西泮、碳酸锂、丙戊酸钠和喹硫平组的CLZ血药浓度低于CLZ单用组, 差异有统计学意义(P<0.05,P<0.01);联用氯硝西泮、碳酸锂、丙戊酸钠、舍曲林、喹硫平和利培酮组的N-CLZ血药浓度低于CLZ单用组, 差异有统计学意义(P<0.05,P<0.01)。Spearman等级相关分析显示:CLZ单用组中,CLZ剂量与CLZ血药浓度、N-CLZ血药浓度三者间两两呈正相关(P<0.05,P<0.01)。结论一些常用精神科药物对氯氮平的血药浓度存在一定程度影响,临床上应加强对联合用药精神障碍患者氯氮平血药浓度监测,及时调整患者的氯氮平剂量。
其他语种文摘 Objective To investigate the effect of various comedications on the plasma concentration of clozapine(CLZ) in inpatients with psychosis disorder. Methods High performance liquid chromatography (HPLC) was used to analyze serum CLZ and norclozapine(N-CLZ) concentrations in 571 psychosis patients. The influence of commedication on plasma CLZ concentration was analyzed using SPSS 17.0 software while considering the dosage of CLZ and the comedications with 12 drugs most often used in combination with CLZ. Results The CLZ dosage, plasma CLZ concentration and plasma N-CLZ concentration in the comedication group were significantly lower than those in pure CLZ group (P<0.01). The CLZ dosage in groups of comedications with clonazepam, paroxetine, venlafaxine, aripiprazole, quetiapine and risperidone were significantly lower than that of pure CLZ group (P<0.05,P<0.01). Comedication with clonazepam, lithium carbonate, valproate and quetiapine significantly decreased the plasma concentration of CLZ (P<0.05,P<0.01). Comedication with clonazepam, lithium carbonate, valproate, sertraline, quetiapine and risperidone significantly decreased the plasma concentration of N-CLZ (P<0.05,P<0.01). Spearman’s correlation analysis found that there were significant positive correlations among any two of dosage CLZ, concentration of CLZ and concentration of N-CLZ in CLZ group (P<0.05,P<0.01). Conclusion Some commonly-used antipsychotics have impact on plasma CLZ concentration. Drug monitoring and dosage regulation of CLZ should be stressed among patients comedicated with clozapine combined with other antipsychotics, so as to timely regulate the dosage of CLZ.
来源 第二军医大学学报 ,2013,34(7):759-763 【核心库】
DOI 10.3724/sp.j.1008.2013.00759
关键词 血药浓度 ; 联合药物疗法 ; 氯氮平 ; 去甲氯氮平
地址

1. 上海交通大学医学院附属上海市精神卫生中心生化药理研究室, 上海, 200030  

2. 浙江省嘉兴市康慈医院, 嘉兴, 314500  

3. 中国科学院心理研究所, 北京, 100101

语种 中文
文献类型 研究性论文
ISSN 0258-879X
学科 神经病学与精神病学;药学
基金 国家自然科学基金 ;  上海市精神卫生中心项目
文献收藏号 CSCD:4897035

参考文献 共 16 共1页

1.  Mercolini L. Simultaneous analysis of classical neuroleptics,atypical antipsychotics and their metabolites in human plasma. Anal Bioanal Chem,2007,388:235-243 被引 3    
2.  Stanworth D. Clozapine: a dangerous drug in a clozapine-naive subject. Forensic Sci Int,2012,214(1/3):e23-e25 被引 2    
3.  Grinevich V P. A typical antipsychotics as noncompetitive inhibitors of alpha4beta2 and alpha7 neuronal nicotinic receptors. Neuropharmacology,2009,57:183-191 被引 2    
4.  Couchman L. Plasma clozapine and norclozapine in patients prescribed different brands of clozapine (Clozaril,Denzapine,and Zaponex). Ther Drug Monit,2010,32:624-627 被引 2    
5.  顾牛范. HPLC检测红细胞内氯氮平浓度. 上海精神医学,1993,5:223-226 被引 2    
6.  Gonzalez-Esquivel D F. Plasma levels of clozapine and norclozapine in Mexican schizophrenia patients. Arzneimittelforschung,2011,61:335-339 被引 1    
7.  Nielsen J. Optimizing clozapine treatment. Acta Psychiatr Scand,2011,123:411-422 被引 4    
8.  Zhou S F. Insights into the substrate specificity,inhibitors,regulation,and polymorphisms and the clinical impact of human cytochrome P450 1A2. AAPS J,2009,11:481-494 被引 5    
9.  汪志良. 氯氮平药物相互作用研究新进展. 中华精神科杂志,2012,45:55-58 被引 4    
10.  付培鑫. 精神药物的治疗药物监测. 中国医院用药评价与分析,2007,7:176-179 被引 4    
11.  Castberg I. Quetiapine and drug interactions: evidence from a routine therapeutic drug monitoring service. J Clin Psychiatry,2007,68:1540-1545 被引 3    
12.  贾竑晓. 丙戊酸钠对氯氮平血药浓度和疗效的影响. 临床精神医学杂志,2007,17:310-311 被引 1    
13.  Rajkumar A P. Clinical predictors of serum clozapine levels in patients with treatment-resistant schizophrenia. Int Clin Psychopharmacol,2013,28:50-56 被引 3    
14.  Gahr M. Pregabalin-associated elevation of clozapine serum levels. Pharmacopsychiatry,2012,45:297-299 被引 2    
15.  周云飞. 影响氯氮平的血药浓度、疗效及副反应因素的研究进展. 中华精神科杂志,2002,35:248-249 被引 4    
16.  盛小奇. 氯氮平治疗精神分裂症血药浓度与剂量、疗效及付反应关系的研究. 中国神经精神疾病杂志,1990,16:90-92 被引 13    
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