摘要
目的探讨度洛西汀血药浓度的主要影响因素,为度洛西汀的个体化用药提供科学依据。方法回顾性选择2022年1月至2024年4月河北医科大学第一医院使用度洛西汀治疗并进行血药浓度监测的434例抑郁障碍住院患者,分析其性别、年龄、体重指数(BMI)、基因表型、合并用药、药品类型(原研/仿制)、基因单核苷酸多态性位点分型结果等对血药浓度及剂量校正后血药浓度(C/D)的影响。结果度洛西汀血药浓度为76.65(45.57,130.31)ng/mL,C/D为[0.96(0.63,1.60)]ng·d/(mL·mg)。度洛西汀日剂量与血药浓度之间存在显著正相关关系(决定系数为0.2537,P<0.001)。38.94%的患者度洛西汀血药浓度超出指南建议范围。性别、年龄、BMI、合用CYP2D6酶抑制剂、CYP2D6和CYP1A2表型对度洛西汀的C/D有显著影响(P<0.05)。结论患者的年龄、性别、BMI、合并用药、基因表型与度洛西汀的血药浓度密切相关。
OBJECTIVE To explore the main factors influencing the blood concentration of duloxetine,and provide a scientific basis for the individualized use of duloxetine.METHODS Retrospective analysis was conducted on 434 inpatients with depressive disorders at the First Hospital of Hebei Medical University,who were treated with duloxetine and underwent blood concentration monitoring between January 2022 and April 2024.The study examined the impact of various factors,including gender,age,body mass index(BMI),gene phenotypes,combined medication,drug type(original/generic),and genotyping results of gene single nucleotide polymorphism loci,on blood concentration and the concentration-to-dose(C/D)after dose adjustment.RESULTS The blood concentration of duloxetine was 76.65(45.57,130.31)ng/mL,and C/D was 0.96(0.63,1.60)ng·d/(mL·mg).The blood concentration of duloxetine was positively correlated with the daily dose of administration(R2=0.2537,P<0.001).Blood concentration of duloxetine in 38.94%of patients exceeded the recommended range specified in the guidelines.Gender,age,BMI,combined use of CYP2D6 enzyme inhibitors,and CYP2D6 and CYP1A2 phenotypes had significant effects on C/D of duloxetine(P<0.05).CONCLUSIONS The patient’s age,gender,BMI,combined medication,and genetic phenotypes are closely related to the blood concentration of duloxetine.
作者
伦杨
段立广
安绯悦
付冉
于静
陈朝丽
赵梦强
苏适
宋洋
王佳琪
闫宇航
周春华
LUN Yang;DUAN Liguang;AN Feiyue;FU Ran;YU Jing;CHEN Chaoli;ZHAO Mengqiang;SU Shi;SONG Yang;WANG Jiaqi;YAN Yuhang;ZHOU Chunhua(Dept.of Clinical Pharmacy,the First Hospital of Hebei Medical University,Shijiazhuang 050023,China;Dept.of Pharmacy,the First Hospital of Hebei Medical University,Shijiazhuang 050023,China;Technology Innovation Center for Artificial Intelligence in Clinical Pharmacy of Hebei Province,Shijiazhuang 050031,China)
出处
《中国药房》
北大核心
2025年第6期727-731,共5页
China Pharmacy
基金
河北省2025年政府资助临床医学优秀人才培养项目(No.ZF2025040)
石家庄驻冀高校重点研发专项(No.241200043A)。
关键词
度洛西汀
基因型
治疗药物监测
抑郁障碍
个体化用药
duloxetine
genotype
therapeutic drug monitoring
depressive disorders
individualized medication
