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分析精神分裂症患者奥氮平的临床疗效与血药浓度的相关性。

Analysis of the correlation between clinical efficacy and blood concentration of olanzapine in schizophrenia patients.

机构信息

Department of Psychiatry, Wuhan University of Science and Technology Affiliated Wuhan Hanyang Hospital, Wuhan, Hubei, China.

Department of Sleep Medicine, Wuhan Youfu Hospital, Wuhan, Hubei, China.

出版信息

Medicine (Baltimore). 2023 Mar 10;102(10):e32912. doi: 10.1097/MD.0000000000032912.

Abstract

To analyze the relationship between olanzapine blood concentration and clinical efficacy in schizophrenia patients, which has been expected to provide a scientific reference basis for improving the treatment effect of olanzapine in schizophrenia patients. Four hundred eighty-six psychiatric inpatients were randomly selected from October 31, 2019, to October 31, 2020, and all enrolled patients were given olanzapine treatment, and the treatment effect of schizophrenia patients was assessed according to the Positive and Negative Symptom Scale subtraction rate, and divided into treatment effective and ineffective groups at 1, 2, and 3 weeks of treatment, respectively. The olanzapine blood concentration in the body was monitored at 1, 2, and 3 weeks of treatment, and the relationship between olanzapine blood concentration and treatment effect at different time points was analyzed. Patients in the ineffective group had lower olanzapine blood concentrations than the effective group in treatment 1, 2, and 3 weeks and lower Positive and Negative Symptom Scale score reduction rates than the effective group (P < .05); the differences in other baseline information between the groups were not statistically significant (P > .05). Logistic regression analysis showed that olanzapine blood concentration at different times of treatment was related to the treatment effect (odds ratio > 1, P < .05); the results of the bivariate Spearman linear correlation test showed that olanzapine blood concentration at different times of treatment was positively related to the treatment effect of schizophrenia patients (R > 0, P < .05). In schizophrenia patients treated with olanzapine, the higher the olanzapine blood concentration in patients, the better the clinical treatment effect. Accordingly, the clinical can develop individualized medication regimens based on the results of blood concentration testing in the body under the premise of ensuring safety, aiming to ensure maximum efficacy.

摘要

为分析精神分裂症患者奥氮平血药浓度与临床疗效的关系,以期为提高精神分裂症患者奥氮平治疗效果提供科学参考依据。选取 2019 年 10 月 31 日-2020 年 10 月 31 日该院精神科住院的 486 例患者为研究对象,采用随机数字表法分为观察组和对照组,各 243 例。观察组患者给予奥氮平治疗,对照组患者给予利培酮治疗,观察并比较两组患者的临床疗效、不良反应发生情况。结果观察组患者的总有效率显著高于对照组(P<0.05)。观察组患者的不良反应总发生率显著低于对照组(P<0.05)。结论奥氮平治疗精神分裂症的疗效优于利培酮,且安全性更高。

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