摘要
目的对照比较利福平对氯氮平(CLOZ)与利增酮(RIS)血药浓度及疗效的影响。方法氯氮平组(CLOZ组)25例和利培酮组(RIS组)15例均为单用CLOZ和RIS治疗的精神分裂症伴肺结核患者,在持续原来CLOZ和RIS剂量治疗两周以上的基础上分别合用利福平(0.45g/日),共治疗6周。分别于研究前与研究后第2、6周末采用高效液相色谱法(HPLC)测定CLOZ和RIS药物血浓度,同期以阳性和阴性症状量表(PANSS)评定精神症状。结果与利福平合用前比较,合用后第2、6周末的氯氮平和利培酮血深度以及去甲基氯氮平和9-羟利培酮血浓度均有显著下降,期间差异经单因素方差分析检验均存在非常显著性意义;CLOZ组患者合用前和第2、6周末的PANSS阳性症状、一般精神病理因子分以及PANSS总分间差异均有非常显著性意义;CLOZ组患者精神症状恶化者为(16人)明显多于RIS组的(4人),差异有显著性意义(χ2=5.23,P<0.05);CLOZ组患者出现精神症状恶化时间为(13.33±5.55)天,明显短于RIS组的(20.25±7.13)天,差异也有显著性意义(t=2.12,P<0.05)。结论精神分裂症伴肺结核患者的药物治疗应该注意药物的相互作用,利培酮比氯氮平更适用于这类患者的治疗。
Objective To explore the effect of rifampicin（RFP） on the blood concentration and efficacy of clozapine （CLOZ） and risperidone （RIS）. Methods A total of 25 schizophrenics with pulmonany tuberculosis treated with CLOZ only for at least 2 weeks were included into the CLOZ group,while 15 schizophrenics with pulmonary tuberculosis treated with RIS only for at least 2 weeks were included into the RIS group. The two groups were treatell with RFP for six weeks. HPLC was used to test the blood concentration of CLOZ and RIS before and at the end of the second and sixth week after the treatment. PANSS was used to evaluate the psychiatric symptoms. Results Atrer the treatment with RFP, both concentrations reduced significantly. There were significant differences in the total scores of PANSS between before the combination and at the end of the second and sixth week after combination in the CLOZ group （F= 9.61, P〈0.01）. There were significantly more patients with psychiatric symptoms in CLOZ group （16） than those in RIS group（4） （X^2 =5.23,P〈0.05）. It was the time that psychiatric symptoms became worse in the CLOZ group （13.33±5.55 days） was significantly earlier than that. In RIS group （20.25±7. 13 days）（t=2. 12,P〈0.05）. Conclusion RIS may be a better choice to treat the psychiatric symptoms for schizophrenia with pulmonary tuberculosis.
出处
《精神医学杂志》
2007年第2期78-80,共3页
Journal of Psychiatry
基金
江苏省金坛市科学技术委员会资助项目(编号TS2005056)
关键词
利福平
氯氮平
利培酮
血药浓度
精神分裂症
肺结核
Rifampicin Clozapine Risperidone Blood concentration Schizophrenia Pulmonary tuberculosis
