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抑郁症患者的帕罗西汀稳态谷浓度参考范围分析
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| 篇名： | 抑郁症患者的帕罗西汀稳态谷浓度参考范围分析 |
| TITLE： | Analysis of reference range for paroxetine steady-state trough concentrations in patients with depression |
| 摘要： | 目的 探讨服用帕罗西汀的抑郁症患者的稳态谷浓度参考范围。方法回顾性收集2023年1月1日至2024年12月31日于我院接受帕罗西汀治疗的890例抑郁症住院患者的血药浓度监测数据。采用单因素分析及多元线性回归分析帕罗西汀稳态谷浓度的影响因素，及其与疗效、不良反应的相关性，通过受试者操作特征（ROC）曲线法确定谷浓度的参考范围。结果疗效改善程度越高的患者的帕罗西汀稳态谷浓度越高（P＜0.0001）。男性和体重60～80kg患者的帕罗西汀稳态谷浓度、帕罗西汀稳态谷浓度与剂量的比值（C/D值）分别显著低于女性和体重＜60kg患者（P＜0.05或P＜0.0001）。稳态谷浓度、C/D值、剂量、联合用药均与疗效呈正相关（P＜0.05或P＜0.0001）。稳态谷浓度及C/D值与肝功能损害、C/D值与尿潴留均有相关性（P＜0.05或P＜0.0001）。总体人群帕罗西汀有效浓度的临界值为56.31ng/mL，男性为56.42ng/mL，女性为44.91ng/mL；发生不良反应患者临界值为198.90ng/mL。结论总体人群的帕罗西汀稳态谷浓度参考范围为56.31～198.90ng/mL，男性为56.42～198.90ng/mL，女性为44.91～198.90ng/mL；女性、低体重、肝功能损害患者服用帕罗西汀时应酌情降低剂量。 |
| ABSTRACT： | OBJECTIVE To investigate the reference range of steady-state trough concentrations in depression patients taking paroxetine. METHODS Therapeutic drug monitoring data of 890 depression inpatients treated with paroxetine in our hospital from January 1， 2023 to December 31， 2024 were retrospectively collected. Univariate analysis and multiple linear regression analysis were employed to explore the influencing factors of the steady-state trough concentration of paroxetine， as well as the correlation between concentration and efficacy and adverse reactions. The reference range of steady-state trough concentration was obtained by receiver operating characteristic（ROC） curve method. RESULTS Patients with a greater degree of improvement in therapeutic efficacy exhibited higher steady-state trough concentrations of paroxetine （P＜0.000 1）. The steady-state trough concentrations of paroxetine and the ratio of paroxetine steady-state trough concentration to dose （C/D ratio） were significantly lower in male patients and those weighing 60-80 kg compared to female patients and those weighing＜60 kg， respectively （P＜0.05 or P＜0.000 1）. The steady-state trough concentration， C/D ratio， dosage， and concomitant medication all showed a positive correlation with therapeutic efficacy （P＜0.05 or P＜0.000 1）. Both the steady-state trough concentration and C/D ratio were correlated with liver function impairment， and the C/D ratio was also correlated with urinary retention （P＜0.05 or P＜0.000 1）. The critical threshold for the effective concentration of paroxetine was 56.31 ng/mL in the overall population， 56.42 ng/mL in males， 44.91 ng/mL in females， and 198.90 ng/mL in patients experiencing adverse reactions. CONCLUSIONS The reference range for the steady-state trough concentration of paroxetine in the overall population is 56.31-198.90 ng/mL； for male patients， it is 56.42-198.90 ng/mL， and for female patients， it is 44.91-198.90 ng/mL. Dosage of paroxetine should be reduced as appropriate for female patients and patients with low body weight or abnormal liver function. |
| 期刊： | 2025年第36卷第16期 |
| 作者： | 林晗；林丽萍；刘银芳 |
| AUTHORS： | LIN Han，LIN Liping，LIU Yinfang |
| 关键字： | 帕罗西汀；抑郁症；血药浓度监测；稳态谷浓度；受试者操作特征曲线法 |
| KEYWORDS： | paroxetine； depression； therapeutic drug monitoring； steady-state trough concentrations； ROC curve method |
| 阅读数： | 8 次 |
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