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目的 :探讨氯氮平靶症状与血药浓度的关系。方法 :收集符合 CCMD- 2 - R精神分裂症诊断标准者 6 3例 ,入组时评定 PANSS量表。随后单服氯氮平达 2 8天 ,并在第 2 8天评定 PANSS,测定氯氮平血药浓度。结果 :4周末血药浓度范围 10 6～ 46 1μg/ L,血药浓度与 PANSS总分及诸因子分的减分率均无相关性 ,但 PANSS某些因子的显效率存在血药浓度治疗窗 ,阴性症状、无反应性、激越、抑郁、附加因子分的窗内显效率高于窗外。结论 :阳性症状的血药浓度治疗窗可能较宽 ;阴性症状和附和症状的血药浓度治疗窗较高 ,抑郁症状的血药浓度治疗窗较低 ,并对其机理作了相应的解释。
Objective: To investigate the relationship between the symptoms of clozapine target and plasma concentration. Methods: Sixty - three patients with schizophrenia diagnosed by CCMD - 2 - R were collected and the PANSS scale was assessed at the time of enrollment. Clozapine was then given orally for 28 days and PANSS was assessed on day 28 for the determination of clozapine plasma concentration. Results: The blood concentration ranged from 106 to 461μg / L at 4weeks. There was no correlation between plasma concentration and the total score of PANSS and the scores of various factors. However, the effective rate of certain factors of PANSS existed in the plasma concentration therapeutic window , Negative symptoms, non-responsive, agitation, depression, additional factor window efficiency significantly higher than the window. Conclusion: The therapeutic window of serum concentration of positive symptoms may be wide. The therapeutic window of plasma concentration of negative symptoms and adjuvant symptoms is higher, and the therapeutic window of plasma concentration of depressive symptoms is lower, and its mechanism is explained accordingly.