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目的 :探讨氯丙咪嗪治疗抑郁症的口服剂量、血药浓度与临床疗效之间关系 ,及其有效血浓度范围。 方法 :符合 CCMD- 2诊断标准的抑郁症病人 30例 ,汉密尔顿抑郁量表 (HAMD)评分2 1～ 45分 ,平均 (34.87± 6 .5 3)分 ;纽卡斯尔抑郁诊断量表 (NDI)评分 6～ 10分进入研究。以不定剂量氯丙咪嗪口服治疗 ,共治疗 8周。以 HAMD减分率评定疗效。荧光免疫偏振分析仪 (TDx)测第14天稳态血药浓度。 结果 :氯丙咪嗪剂量 2 5～ 10 0 m g/ d时血浓度范围变异很大 [46～ 44 7ng/ ml,平均 (183± 86 ) ng/ m l];口服剂量与血药浓度呈非线性相关 (P<0 .0 5 ) ;血药浓度与临床疗效显著相关(r=- 0 .5 5 2 ,P=0 .0 0 16 ) ,呈指数曲线关系。 结论 :氯丙咪嗪有效血浓度在 12 6～ 40 0 ng/ ml之间 ,临床长期使用应以血药浓度监测手段指导
Objective: To investigate the relationship between oral dose of clomipramine in the treatment of depression, plasma concentration and clinical efficacy, and its effective blood concentration range. Methods: Thirty patients with depression were diagnosed according to CCMD-2. The HAMD score was 2145, with an average of (34.87 ± 6.35) points. The Newcastle depression diagnostic scale (NDI) score was 6 ~ 10 points into the study. To varying doses of clomipramine oral treatment, a total of 8 weeks. HAMD reduction rate assessment of efficacy. Fluorescence immuno polarization analyzer (TDx) measured on the 14th steady-state plasma concentration. Results: Serum variability ranged from 46 to 44 7 ng / ml (mean, (183 ± 86) ng / ml) at oral doses of 25 to 100 mg / day. The oral dose and plasma concentration were nonlinear (P <0.05). The plasma concentration was significantly correlated with clinical efficacy (r = - 0.552, P = 0.060), showing an exponential curve. Conclusion: The effective blood concentration of clomipramine is between 12 6 ~ 40 0 ng / ml. The long-term clinical use should be guided by the means of blood concentration monitoring