度洛西汀在抑郁症患者中血药浓度/剂量比的影响因素研究OACSTPCD

OBJECTIVE:To probe into the influencing factors of blood concentration/dose ratio(C/D)after oral administration of duloxetine in patients with depression,so as to provide reference for clinical implementation of individualized medication.METHODS:A total of 264 samples of blood concentration monitoring data of inpatients receiving duloxetine in our hospital from 2020 to 2022 were retrospectively collected,the effects of gender,age,nationality,body mass index(BMI),complicating disease,drug combination,drug manufacturer and smoking on C/D value of duloxetine were analyzed.RESULTS:The mean daily dose of duloxetine was(54.55±13.10)mg/d,the mean steady-state blood concentration was(69.14±22.87)ng/mL,and the mean C/D value was(1.44±0.62)ng·d/(mL·mg).The C/D value of duloxetine in female patients was significantly higher than that in male patients(P<0.05);the C/D value of duloxetine in patients of Hui nationality was significantly higher than those of Kazak nationality(P<0.01);the C/D value of duloxetine in normal group(BMI from 18.5 to<24.0)and overweight group(BMI from 24.0 to<28.0)were higher than that in obese group(BMI≥28.0)(P<0.05);the C/D value of duloxetine in patients received drug combination of olanzapine and trazodone were higher than that of quetiapine(P<0.05);the C/D value of duloxetine in patients complicated with hypertension was higher than that with no complicating disease(P<0.05),the differences were statistically significant.There was no correlation between drug manufacturers and the C/D value of duloxetine(P>0.05),the correlation between age and smoking and the C/D value of duloxetine still needed to be verified by further expanding sample size.CONCLUSIONS:Duloxetine has large inter-individual pharmacokinetic differences,the gender,nationality,BMI,complicating disease and drug combination can cause fluctuations in blood concentration of duloxetine,therefore,clinicians or pharmacists should adjust and optimize the individual dosing regimen in combination with patient's blood concentration and clinical efficacy in time.