奥氮平在精神分裂症中的血清药物浓度/剂量比影响因素研究

目的:探讨影响精神分裂症患者服用奥氮平后血清药物浓度/剂量比（C/D）的因素。方法:回顾性收集了2018年本院304例精神分裂症住院患者的病例资料并查阅入组患者的病历与医嘱，计算奥氮平C/D值，分别考察性别、年龄、BMI、药物来源（国产或进口）、吸烟、合并用药、CYP1A2代谢酶基因型对奥氮平C/D值的影响。结果:男性患者的C/D均值为（2.59±1.08） ng·mL-1·mg-1·d，女性患者的C/D均值为（3.14±1.80） ng·mL-1·mg-1·d，女性患者的C/D均值在统计学上显著高于男性患者的C/D均值（P=0.032）。联合使用肝药酶诱导剂或抑制剂会显著影响患者的C/D值；吸烟会显著降低奥氮平的C/D值（P=0.024）；不同年龄与CYP1A2基因型患者的C/D值没有统计学差异；BMI与奥氮平的来源对患者的C/D值没有显著性影响。结论:患者服用奥氮平后的C/D值主要与患者的性别、合并用药以及是否吸烟有关，同时也需要充分考虑患者的基因型。

Influential factors of serum concentration/dosage ratio for schizophrenia patients after oral administration of olanzapine

AIM: To investigate the factors affecting the serum concentration/dose ratio of olanzapine in schizophrenic patients. METHODS: The data of 304 schizophrenic inpatients in our hospital in 2018 were retrospectively collected, and the patients' medical records and medical orders were consulted. The C/D values of olanzapine were calculated. The effects of gender, age, BMI, source of olanzapine (domestic or imported), smoking, combined use of drugs and CYP1A2 metabolic enzyme genotype polymorphism on the C/D values were studied. RESULTS:The C/D mean value of male patients was (2.59±1.08) ng·mL-1·mg-1·d, and that of female patients was (3.14±1.80) ng·mL-1·mg-1·d. The C/D mean of female patients was significantly higher than that of male patients (P=0.032). The combination of hepatic enzyme inducers or inhibitors could significantly affect the C/D value of patients. Smoking could significantly reduce the C/D value of patients (P=0.024). The C/D value of patients with different ages and CYP1A2 genotype showed no significantly difference. BMI and the source of olanzapine (domestic or imported) had no significant effect on the C/D value of patients. CONCLUSION:The C/D value of olanzapine is mainly related to the gender of patients and the combination of drugs and smoking, and the genotype of patients should be fully considered.