【摘要】 目的　探讨不同类型、不同严重程度的慢性病毒性肝炎对氯氮平及去甲氯氮平血药浓度的影响。方法　对 92例合并慢性病毒性肝炎 (分慢性迁延性肝炎、慢性活动性肝炎两型及轻度、中度、重度三种严重程度 )的精神分裂症病人 (慢性肝炎组 )以及 4 0例无肝脏疾病的精神分裂症病人 (对照组 ) ,分别于服药 2周末、6周末检测氯氮平血药浓度。结果　慢性肝炎组与对照组氯氮平浓度有显著差异 ,去甲氯氮平浓度无显著差异。中度、重度慢性肝炎组及慢性活动性肝炎组与对照组氯氮平浓度均有显著差异 ,轻度慢性肝炎组及慢性迁延性肝炎组与对照组氯氮平浓度均无显著差异 ,各型及各严重程度慢性肝炎组与对照组去甲氯氮平浓度均无显著差异。结论　中度、重度慢性肝炎及慢性活动性肝炎对氯氮平浓度的影响明显 ,而轻度慢性肝炎及慢性迁延性肝炎对氯氮平浓度的影响不明显 ,慢性肝炎对氯氮平浓度的影响明显大于对去甲氯氮平浓度的影响。因此在临床上 ,对合并不同类型不同严重程度慢性病毒性肝炎的精神分裂症病人使用氯氮平时剂量应相应减少 ,并有监测氯氮平浓度之必要更多还原

【Abstract】 Objective To study the serum concentration of clozapine affected by different type and variable severity of chronic viral hepatitis.Method 92 cases of schizophrenia with chronic viral hepatitis,divided into chronic persistent hepatitis(CPH),chronic active hepatitis(CAH) as well as mild,middle and severe groups,and 40 schizophrenic patients without any hepatosis(controls) were tested for serum concentration of clozapine after 2 and 6 weeks of taking clozapine.Results The serum concentration of clozapine in group of chronic hepatitis has significant difference from that in controls,but the serum concentration of norclozapine in group of chronic hepatitis has little difference.The serum concentration of clozapine on middle,severe chronic hepatitis and CAH are significantly different from that in controls,where the mild chronic hepatitis and CPH have no difference.The serum concentration of norclozapine in all groups of chronic hepatitis has little difference from that in controls.Conclusion Middle,severe chronic hepatitis and CAH has significant difference on serum concentration of clozapine,but mild chronic hepatitis and CPH has no significant effect on it.Moreover chronic hepatitis has much more effect on serum concentration of clozapine than that of norclozapine.Dose of clozapine should be reduced accordingly in schizophrenic patients,accompanied with different type and variable severity of chronic hepatitis,and serum concentration of clozapine is necessary to measure timely.更多还原