精神分裂症患者氨磺必利血药浓度剂量比和高泌乳素血症的影响因素分析OA

Objective To investigate the influential factors of the concentration/dose ratio(C/D)and hyperprolactinemia(HPRL)of amisulpride tablets and provide the reference for the rational clinical use of this drug.Methods Schizophrenic inpatients who underwent amisulpride tablets therapeutic drug monitoring(TDM)were included in this study.General information and amisulpride serum concentrations were collected through the medical record system.Data analysis was carried out through the SPSS 26.0 software.Results A total of 551 inpatients were included,the daily dose of amisulpride tablet was 600(400,800)mg·d-1,serum concentration was 399.80(260.40,575.80)ng·mL-1 and C/D was 0.71(0.49,0.95)ng·mL-1·mg-1.The C/D ratios of amisulpride tablets among women and men were 0.81(0.58,1.06)and 0.63(0.43,0.86),with statistically significant differences(P＜0.05).Age and estimated glomerular filtration rate(eGFR)level both did not affect the C/D ratio of amisulpride,with no statistically significant differences(all P＞0.05).The C/D ratio of overweight,obese group and underweight group were 0.56(0.41,0.91),0.64(0.47,0.89)and 0.87(0.55,1.13),respectively,with statistically significant difference when compared overweight,obese group with underweight group(all P＜0.05).The C/D ratios of amisulpride tablets in patients with and without clozapine use were 0.81(0.57,1.13)and 0.67(0.47,0.91),respectively;the C/D ratios in patients with and without aripiprazole use were 0.83(0.63,1.07)and 0.70(0.48,0.93),respectively;the C/D ratios in patients with and without olanzapine use were 0.59(0.46,0.84)and 0.72(0.50,0.97),respectively;and the C/D ratios of amisulpride tablets in patients with and without lorazepam use were 0.61(0.41,0.87)and 0.72(0.51,0.96),respectively.The differences in the C/D ratios of amisulpride tablets between the use and non-use groups were statistically significant in all cases(all P＜0.05).195 patients(97.01％)had HPRL after medication,multiple linear regression analysis indicated that gender and body mass index(BMI)all statistically significantly influenced HPRL(all P＜0.05).Conclusion The C/D ratios of amisulpride are affected by gender,BMI,clozapine comedication,aripiprazole comedication,olanzapine comedication and lorazepam comedication.In addition,woman and underweight patients need pay more attention to PRL level after medication.