中国临床药学杂志2025，Vol.34Issue(4)：283-288,6.DOI:10.19577/j.1007-4406.2025.04.008
某三甲医院8种非典型抗精神病药物的治疗药物监测异常率及其影响因素
Abnormal rate of therapeutic drug monitoring and its influencing factors of 8 atypical antipsychotic drugs in a tertiary hospital
摘要
Abstract
AIM A retrospective cohort study was conducted to analyze therapeutic drug monitoring(TDM)abnormalities of 8 atypical antipsychotics and investigate their correlation with age and gender using multivariate logistic regression.METHODS Therapeutic drug monitoring(TDM)data were collected for 8 atypical antipsychotics(olanzapine,risperidone,quetiapine,clozapine,aripiprazole,amisulpride,ziprasidone,and paliperidone)in hospitalized patients.Steady-state trough concentrations of 8 atypical antipsychotics were determined by liquid chromatography-tandem mass spectrometry.TDM results were defined as abnormal when drug concentrations fell below the lower limit or exceeded the upper limit of their respective reference therapeutic ranges,followed by the calculation of abnormality rates.Abnormal rates were stratified and statistically compared among 3 age groups(young adults:18-44 years,middle-aged:45-64 years,elderly:≥ 65 years)and by gender(male vs female).RESULTS A total of 17 088 TDM results were collected,with 6 449 abnormal TDM results and an abnormality rate of 37.74％.Among the 8 atypical antipsychotics,clozapine had the highest abnormal rate(67.74％),followed by quetiapine(47.18％),aripiprazole(43.77％),paliperidone(42.46％),amisulpride(37.58％),olanzapine(25.11％),ziprasidone(24.19％),and risperidone(22.22％).In addition,there were significant differences in TDM abnormalities across various ages(x2=68.411,P＜0.001)with the highest abnormal rate in the elderly groups(41.97％),and different gender(x2=24.118,P＜0.001)showing the higher proportion of abnormalities in males(39.98％).CONCLUSION Patients using atypical antipsychotics had different degrees of abnormal blood concentrations,especially elderly male patients.Thus,TDM should be further strengthened based on the efficacy-guided protocols,with dosing regimens optimized by individualized blood concentration profiling,enhancing therapeutic precision and advancing evidence-based rational medication use.关键词
非典型抗精神病药/治疗药物监测/异常率/年龄/性别Key words
atypical antipsychotics/therapeutic drug monitoring/abnormal rate/age/gender分类
药学引用本文复制引用
栾燕,王凤赫,郭红智,陈春武..某三甲医院8种非典型抗精神病药物的治疗药物监测异常率及其影响因素[J].中国临床药学杂志,2025,34(4):283-288,6.基金项目
辽宁省自然科学基金(编号2024-MS-278) （编号2024-MS-278）
