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目的探讨利福平对利培酮血药浓度的影响,为精神分裂症伴肺结核患者合理使用利培酮提供临床依据。方法30例精神分裂症伴肺结核患者随机分成两组,利福平加利培酮(合并组)和单用利培酮(对照组)各15例。在持续原来利培酮剂量治疗两周以上的基础上,合并组加用利福平(0.45g/次,qd),对照组继续单用利培酮,共治疗6周。分别于研究前与研究后第2、6周末采用高效液相色谱法(HPLC)测定利培酮血浓度及活性代谢产物9-羟利培酮的血浓度。结果合并组患者利培酮及活性代谢产物的血浓度明显下降,最大降幅出现在第2周末,分别为69.6%和74.1%;合用后第2、6周末利培酮及9-羟利培酮血浓度与研究前比较,经方差分析差异均有非常显著性意义,与对照组比较差异亦有非常显著意义。结论利福平对利培酮血药浓度存在一定程度的影响,临床合用过程中应加强利培酮血浓度的监测。
Objective To investigate the effect of rifampicin on risperidone plasma concentration and to provide a basis for rational use of risperidone in patients with schizophrenia and pulmonary tuberculosis. Methods Thirty patients with schizophrenia and pulmonary tuberculosis were randomly divided into two groups: rifampicin plus risperidone (combination group) and risperidone alone (control group). Risperidone (0.45g / qd, qd) was added to the combined group and risperidone alone for 6 weeks after the original dose of risperidone continued for more than two weeks. The blood concentration of risperidone and the concentration of active metabolite 9-hydroxy-risperidone were determined by high performance liquid chromatography (HPLC) before the study and at the end of the second and sixth week after the study. Results The blood concentration of risperidone and active metabolites decreased significantly in the combined group, with the maximum decrease occurring at 69.6% and 74.1% at the end of the second week respectively. After the combined use of risperidone and 9-hydroxyrisperidone Blood concentration compared with before the study, the analysis of variance were significant differences, compared with the control group also have very significant significance. Conclusion Rifampicin has a certain degree of influence on risperidone plasma concentration, and the monitoring of risperidone blood concentration should be strengthened during clinical use.