联用氯硝西泮对精神分裂症患者氯氮平、N-去甲氯氮平血药浓度影响的回顾性研究

PSYCH OpenIR > 健康与遗传心理学研究室

	联用氯硝西泮对精神分裂症患者氯氮平、N-去甲氯氮平血药浓度影响的回顾性研究
其他题名	Effect of clonazepam co-administered with clozapine on the serum clozapine and norclozapine concentration of patients with schizophrenia： A Retrospective Survey
	Jiang Ping 1; Lin Zhiguang 1; Jin Yi2 ; Ren Juanjuan 1; Liu Hongmei 1; Cui Huiru 1; Wang Jijun 1; Li Chunbo 1
摘要	背景：对精神分裂症患者,氯氮平（CLZ）有时是与氯硝西泮（CLNAZ）联合使用的。然而,联用氯硝西泮（CLNAZ）和氯氮平（CLZ）对氯氮平和主要代谢产物N-去甲氯氮平（N-CLZ）的血清浓度的影响尚不清楚。目标：调查联用氯硝西泮（CLNAZ）对精神分裂症患者氯氮平（CLZ）血药浓度的影响。方法：应用高效液相色谱技术（HPLC）测定341例服用CLZ的住院精神分裂症患者CLZ及N-CLZ的血药浓度;并运用逐步回归法分析年龄、性别、CLZ剂量、联用CLNAZ等因素对于CLZ血药浓度的影响。结果：（1）联用CLNAZ可影响CLZ血药浓度和N-CLZ血药浓度（p=0.010,p=0.020）;（2）性别、CLZ剂量、联用CLNAZ三因素可影响CLZ血药浓度（p=0.010,p=0.009,p〈0.001）。CLZ血药浓度与女性、CLZ剂量呈正相关;与联用CLNAZ呈负相关;（3）CLZ剂量、联用CLNAZ两因素可影响N-CLZ血药浓度（p=0.020,p〈0.001）。N-CLZ血药浓度与CLZ剂量呈正相关;与联用CLNAZ呈负相关。结论：联用CLNAZ可对精神分裂症患者的CLZ、N-CLZ血药浓度产生影响;而性别和CLZ剂量等因素对精神分裂症患者的CLZ、N-CLZ血药浓度亦有一定程度的影响。临床上应加强联用氯硝西泮的精神分裂症患者CLZ血药浓度监测,及时调整氯氮平剂量。
其他摘要	Background： For patients with schizophrenia clozapine （CLZ） is sometimes co-prescribed with clonazepam （CLNAZ）. However, the impact of administration of CLZ along with CLNAZ on the serum concentration of CLZ and its major metabolite N-CLZ in schizophrenia is not well understood. Aim： To investigate the effects of CLNAZ co-medication, patient gender, age and CLZ dosage on serum concentration of CLZ and norclozapine （N-CLZ） in individuals with schizophrenia. Methods： Serum CLZ and N-CLZ concentrations and demographic data were retrospectively analyzed for 341 patients with schizophrenia. We used SPSS 21.0 to perform stepwise regression to analyze the concentration data and demographics. Variables included in the analysis were： serum concentration of CLZ, N-CLZ, and CLZ dosage, gender, age and CLNAZ co-medication. Results：（1） CLNAZ co-medication significantly affects serum CLZ and N-CLZ concentration in schizophrenics （p=0.010, p=0.020）; （2） CLNAZ co-medication, gender and CLZ dosage significantly affect serum CLZ concentration in patients with schizophrenia （p=O.010, p=0.009, p〈0.001）. Serum CLZ concentration is negatively correlated with CLNAZ co-medication, and is positively correlated with being female and CLZ dosage; （3） CLNAZ co-medication and CLZ dosage were significantly related to serum N-CLZ concentration in participants （p=O.020, p〈0.001）. Serum N-CLZ concentration was negatively correlated with CLNAZ co- medication, and positively correlated with CLZ dosage. Conclusion： CLNAZ co-medication is associated with changes in serum CLZ and N-CLZ concentration. It is indicated that gender and/or CLZ dosage are also related to serum CLZ and N-CLZ concentration. Therapeutic drug monitoring and dosage regulation of CLZ should be performed for patients with schizophrenia who are also taking CLNAZ to maintain a safe and effective serum concentration of CLZ and N-CLZ.
关键词	血药浓度联合用药氯氮平去甲氯氮平氯硝西泮
	2016
语种	中文
发表期刊	上海精神医学
ISSN	1002-0829
卷号	28.0 期号:006 页码:318-325
收录类别	CSCD
CSCD记录号	CSCD:5874359
引用统计	被引频次：1[CSCD] [CSCD记录]
文献类型	期刊论文
条目标识符	http://ir.psych.ac.cn/handle/311026/35533
专题	健康与遗传心理学研究室
作者单位	1.上海交通大学医学院 2.中国科学院心理研究所
推荐引用方式 GB/T 7714	Jiang Ping,Lin Zhiguang,Jin Yi,等. 联用氯硝西泮对精神分裂症患者氯氮平、N-去甲氯氮平血药浓度影响的回顾性研究[J]. 上海精神医学,2016,28.0(006):318-325.
APA	Jiang Ping.,Lin Zhiguang.,Jin Yi.,Ren Juanjuan.,Liu Hongmei.,...&Li Chunbo.(2016).联用氯硝西泮对精神分裂症患者氯氮平、N-去甲氯氮平血药浓度影响的回顾性研究.上海精神医学,28.0(006),318-325.
MLA	Jiang Ping,et al."联用氯硝西泮对精神分裂症患者氯氮平、N-去甲氯氮平血药浓度影响的回顾性研究".上海精神医学 28.0.006(2016):318-325.