河北医科大学学报 ›› 2025, Vol. 46 ›› Issue (5): 617-620,封三.doi: 10.3969/j.issn.1007-3205.2025.05.020

• • 上一篇    

奥氮平联合丙戊酸钠在治疗双相情感障碍中血药浓度与疗效的研究分析

  

  1. 江苏省淮安市第三人民医院药学部，江苏 淮安 223001

  • 出版日期:2025-05-25 发布日期:2025-05-23
  • 作者简介:尹杰（1982-），男，江苏淮安人，江苏省淮安市第三人民医院主管药师，理学学士，从事药学研究。

  • 基金资助:
    江苏省自然科学基金项目（BK20200274）

Study and analysis of plasma concentration and therapeutic efficacy of olanzapine combined with sodium valproate in the treatment of bipolar disorder

  1. Department of Pharmacy, the Third People′s Hospital of Huai′an City, Jiangsu Province, Huai′an 223001, China

  • Online:2025-05-25 Published:2025-05-23

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摘要： 目的 本研究旨在探讨奥氮平与丙戊酸钠联合治疗双相情感障碍患者的血药浓度与疗效之间的关系。
方法 将2020年7月—2023年1月收治的100例双相情感障碍患者纳入研究对象，奥氮平组33例，丙戊酸钠组33例，奥氮平与丙戊酸钠联合组34例。3组均接受相应治疗7个周期。治疗后，检测各组患者的血药浓度，采用精神行为症状评估量表（Positive and Negative Syndrome Scale，PANSS）评估行为症状改善情况，采用躁狂症状量表（Bipolar Rating Scale for Mania，BRMS）和汉密尔顿抑郁症状量表（Hamilton Depression Rating Scale，HAMD）评估治疗效果，并绘制药物量效曲线衡量奥氮平与丙戊酸钠的治疗效果。
结果 研究结果显示，联合组在治疗15 d和30 d后，奥氮平的剂量分别为（5.03±0.21）mg/d和(5.12±0.26) mg/d，丙戊酸钠的血药浓度分别为（593.02±20.28） μg/L和（612.98±21.27） μg/L。相较于治疗前，奥氮平的血药浓度经过30 d的治疗有显著增加，从（27.58±1.36） μg/L至（29.53±1.59） μg/L。而丙戊酸钠的血药浓度变化更为显著，从（53.39±5.53） μg/L上升至（84.96±6.59） μg/L，差异均有统计学意义（P＜0.05）；奥氮平与丙戊酸钠联合组在改善精神行为症状和疗效改善方面均显著优于单独应用奥氮平组或丙戊酸钠组（P＜0.05）。
结论 奥氮平与丙戊酸钠联合治疗能有效调整双相情感障碍患者的血药浓度，并提高治疗疗效，为临床治疗双相情感障碍提供了新的治疗策略。


关键词: 双相情感障碍, 奥氮平, 丙戊酸

Abstract: Objective To explore the relationship between plasma concentration and therapeutic efficacy of olanzapine combined with sodium valproate in patients with bipolar disorder. 
Methods A total of 100 patients with bipolar disorder were included in the study from Jul. 2020 to Jan. 2023 and divided into three groups: the olanzapine group (n=33), the sodium valproate group (n=33), the combination of olanzapine and sodium valproate group (combination group) (n=34). All three groups received corresponding treatment for seven cycles. After treatment, the plasma concentration in each group was measured, and the improvement of symptoms was evaluated using Positive and Negative Syndrome Scale (PANSS). Bech-Rafaelsen Mania Rating Scale (BRMS) and Hamilton Depression Rating Scale (HAMD) were used to evaluate the therapeutic efficacy, and a dose-response curve was drawn to measure the therapeutic efficacy of olanzapine and sodium valproate. 
Results The research results showed that for the combination group, the doses of olanzapine were (5.03±0.21) mg/d and (5.12±0.26) mg/d respectively at 15 and 30 d after treatment, and the plasma concentrations of sodium valproate were (593.02±20.28) μg/L and (612.98±21.27) μg/L, respectively. Compared with those before treatment, the blood concentration of olanzapine significantly increased at 30 d after treatment, from (27.58±1.36 ) μg/L to (29.53±1.59) μg/L, and the blood concentration of sodium valproate showed a more significant change, increasing from (53.39±5.53) μg/L to (84.96±6.59) μg/L, suggesting significant differences (P＜0.05). The combination group of olanzapine and sodium valproate showed significant improvement in both psychiatric and behavioral symptoms and efficacy compared with the olanzapine group or the sodium valproate group (P＜0.05). 
Conclusion The combination therapy of olanzapine and sodium valproate can effectively adjust the plasma concentration of patients with bipolar disorder and improve therapeutic efficacy, providing a new treatment strategy for clinical treatment of bipolar disorder. 

Key words: bipolar disorder, olanzapine, valproic acid

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