血浆氯氮平浓度可预测难治性精神分裂症的临床反应。
Plasma clozapine concentrations predict clinical response in treatment-resistant schizophrenia.
作者信息
Potkin S G, Bera R, Gulasekaram B, Costa J, Hayes S, Jin Y, Richmond G, Carreon D, Sitanggan K, Gerber B
机构信息
Department of Psychiatry and Human Behavior, University of California Irvine Medical Center, Orange 92668.
出版信息
J Clin Psychiatry. 1994 Sep;55 Suppl B:133-6.
Steady-state blood clozapine concentrations in 58 schizophrenic patients varied more than 45-fold (40-1911 ng/mL) after fixed-dose treatment (400 mg/day). Discriminant function analysis determined that a blood clozapine concentration of 420 ng/mL optimally distinguished responders from nonresponders. After 4 weeks of treatment, only 8% of those patients with a blood clozapine concentration < 420 ng/mL responded compared with 60% of those who had a blood clozapine concentration > 420 ng/mL. When plasma concentrations were increased above 420 ng/mL (by a double-blind random assignment procedure), nonresponders increased their response rate to 73% if their plasma concentrations at Week 12 exceeded 420 ng/mL compared with a response rate of 29% if their Week 12 levels remained below 420 ng/mL (chi 2 = 4.2, p < .04).
58例精神分裂症患者在固定剂量治疗（400毫克/天）后，稳态血氯氮平浓度变化超过45倍（40 - 1911纳克/毫升）。判别函数分析确定，血氯氮平浓度为420纳克/毫升时能最佳地区分反应者与无反应者。治疗4周后，血氯氮平浓度<420纳克/毫升的患者中只有8%有反应，而血氯氮平浓度>420纳克/毫升的患者中有60%有反应。当血浆浓度升高至420纳克/毫升以上时（通过双盲随机分配程序），如果第12周时血浆浓度超过420纳克/毫升，无反应者的反应率提高到73%，而如果第12周时浓度仍低于420纳克/毫升，反应率为29%（卡方 = 4.2，p < 0.04）。
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