精神分裂症患者帕利哌酮血浓度与临床疗效相关性研究

摘要

Objective: To examine the correlation between paliperidone plasma concentration and clinical efficacy in the patients with schizophrenia. Methods:Totally 50 schizophrenia patients were treated by paliperidone. The plasma concentration of paliperidone was monitored by RP-HPLC at the weekend of the 2 nd, 4 th and 6 th week, the clinical efficacy was evaluated using the positive and negative syndrome scale ( PANSS) , and the correlation between paliperidone plasma concentration and clinical efficacy was analyzed. Results:The mean plasma concentration of paliperidone was (31. 89 ± 17. 36) ng·ml-1 at the weekend of the 6th week, and no cor-relation was found between paliperidone plasma concentration and the clinical efficacy (r=0. 146,P=0. 074). Paliperidone plasma concentration in 12 patients with adverse drug reactions (ADR) was higher than that in the patients without ADR [(45. 87 ± 19. 21)ng ·ml-1 vs (27. 06 ± 11. 13) ng·ml-1, P <0. 01]. Conclusion: Paliperidone plasma concentration shows significant individual differences. With the increase of paliperidone plasma concentration, clinical efficacy isn't necessarily improved, while the incidence of ADR may be increased. Therefore, the monitoring of paliperidone plasma concentration is recommended to optimize the therapeutic reg-imen.%目的：：探讨精神分裂症患者体内帕利哌酮血浓度与临床疗效的关系。方法：采用反相高效液相色谱法测定50例精神分裂症患者治疗2,4,6周末的帕利哌酮血浓度,采用阳性与阴性症状量表( PANSS)评定治疗2,4,6周末临床疗效,并对帕利哌酮血浓度与临床疗效进行相关性分析。结果：治疗6周末的帕利哌酮平均血浓度为(31.89±17.36) ng·ml-1,帕利哌酮血浓度与临床疗效无相关性(r=0.146,P=0.074)。发生药品不良反应的12例患者的帕利哌酮血浓度为(45.87±19.21)ng ·ml-1,明显高于未发生不良反应的38例患者的帕利哌酮血浓度(27.06±11.13) ng·ml-1(P<0.01)。结论：帕利哌酮血浓度个体差异较大,随着帕利哌酮血浓度的增加,不一定增加临床疗效,但发生不良反应的可能性增加。建议进行帕利哌酮血浓度监测,以优化治疗方案。