帕罗西汀治疗抑郁症患者的血药浓度影响因素及参考范围研究

A Study on the Factors Influencing the Blood Concentration and Reference Range of Paroxetine in the Treatment of Patients with Depression

摘要: 目的：本研究旨在探讨帕罗西汀在治疗药物监测中血药浓度的相关影响因素，并建立我院帕罗西汀血药浓度参考区间，为临床安全、合理地使用帕罗西汀提供参考。方法：收集我院2021年1月至2023年12月服用帕罗西汀治疗抑郁症达稳态血药浓度患者监测数据共272例统计学资料，考察性别、年龄、日剂量、民族、联合用药对帕罗西汀稳态谷浓度的影响，并建立帕罗西汀血药浓度参考区间，结合病例情况分析影响帕罗西汀稳态血药浓度的影响因素。结果：研究初步确定我院患者使用帕罗西汀治疗抑郁症时不同性别稳态血药浓度的参考区间。在相同日给药剂量下不同年龄、不同联合用药、不同民族患者帕罗西汀血药浓度的差异无统计学意义(P > 0.05)。但在30 mg/d和40 mg/d的剂量下，男性与女性的血药浓度存在显著差异(P < 0.05)。结论：我院帕罗西汀在治疗抑郁症稳态血药浓度参考区间，男性参考区间为：28.91~104.0 ng/mL、女性参考区间为：33.46~124.39 ng/mL。性别是影响帕罗西汀稳态血药浓度的重要因素，女性在相同给药剂量条件下，其平均稳态血药浓度高于男性，可能与性别在药物代谢过程中的生理差异有关，如体内脂肪含量、激素水平等因素影响药物的分布与清除。

Abstract: Objective: The aim of this study is to explore the relevant influencing factors of paroxetine blood concentration in therapeutic drug monitoring, and to establish the reference interval of paroxetine blood concentration in our hospital, so as to provide reference for the safe and reasonable use of paroxetine in clinical practice. Methods: A total of 272 cases of statistical data were collected from January 2021 to December 2023 from our hospital to take paroxetine to treat depression up to steady-state blood concentration patients monitoring data, to investigate the influence of gender, age, daily dose, ethnicity, and combination of drugs on the steady-state trough concentration of paroxetine, and to establish the reference interval of paroxetine blood concentration, combined with the case situation to analyse the impact of the influence of the steady-state blood concentration of paroxetine factors. Results: The study preliminarily determined the reference intervals for steady state blood concentrations of different genders in the treatment of depression with paroxetine in our patients. The differences in paroxetine blood concentrations in patients of different ages, different combinations of medications, and different ethnicities at the same daily administered dose were not statistically significant (P > 0.05). However, there was a significant difference in blood concentrations between males and females at doses of 30 mg/d and 40 mg/d (P < 0.05). Conclusion: The reference intervals of steady state blood concentration of paroxetine in the treatment of depression in our hospital were 28.91~104.0 ng/mL in men and 33.46~124.39 ng/mL in women. Gender is an important factor affecting the steady state blood concentration of paroxetine, and the mean steady state blood concentration of women was higher than that of men under the condition of the same dosage of the drug administered, which may be related to gender Physiological differences in drug metabolism, such as body fat content, hormone levels and other factors affecting the distribution and clearance of the drug.