精神分裂症患者血脂水平对奥氮平血浆药物浓度的影响

摘要

Objective To investigate the relationship between blood lipid levels and plasm concentrations of olanzapine in schiz-ophrenic patients. Methods A total of 104 schizophrenic patients treated with olanzapine were divided into hyperlipidemic group(n= 29)and normolipidemic group(n = 75),according to the diagnosetic criterion of the Prevention and Therapy Guidlines about Chi-nese Adults Dyslipdidemia published in 2007. Triglyceride(TG),total cholesterol(TC),high - density lipoprotein cholesterol(HDL- C),low - density lipoprotein cholesterol(LDL - C),renal function(creatinine,urea),hepatic function(albumin,alanine trans-aminase(ALT),aspartate transaminase(AST)and olanzapine plasma concentrations were messured. Results There was no signifi-cant difference in gender,age,urea,renal function(creatinine,albumin),hepatic function(ALT,AST)between two groups(P >0. 05). There was no significant difference in olanzapine doses between two groups(P >0. 05),but the olanzapine plasma concentrations of hyperlipidemic group was significant lower than that of normolipidemic group(P <0. 05). Multiple linear regression analysis showed that triglyceride(TG)was a independent factor influencing the olanzapine plasma concentrations,regression coefficient was negative(P <0. 05). Conclusion Hypertriglyceride probably decreased olanzapine plasma concentrations in schizophrenic patients.%目的：探讨精神分裂症患者血脂水平与奥氮平血浆浓度之间的关系。方法根据2007年中国成人血脂防治指南推荐标准，将104例服用奥氮平治疗的符合《中国精神障碍分类与诊断标准（第3版）》（CCMD -3）的精神分裂症患者分为高脂血症组（n ＝29）和血脂正常组（n ＝75）。测定患者甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL - C）、高密度脂蛋白胆固醇（HDL - C）、肾功能（肌酐、尿素）、肝功能（白蛋白、谷丙转氨酶（ALT）、谷草转氨酶（AST）及奥氮平血浆浓度。结果两组患者性别构成、年龄、肾功能（尿素、肌酐）、肝功能（白蛋白、ALT、AST）等指标差异均无统计学意义（ P ＞0.05）。两组患者服用奥氮平剂量差异无统计学意义（ P ＞0.05），但高脂血症组血浆奥氮平浓度低于血脂正常组药物浓度（ P ＜0.05）。多重线性回归分析显示甘油三酯（TG）是影响奥氮平血浆浓度的独立因素，回归系数为负（P ＜0.05）。结论精神分裂症患者高甘油三酯水平有可能降低奥氮平血浆浓度。