氟伏沙明血浆浓度和成人患者的OCD症状缓解要点.doc

氟伏沙明血浆浓度和成人患者的OCD症状/缓解 Donatella Marazziti*, Stefano Baroni, Gino Giannaccini, Armando Piccinni, Michela Picchetti, Gabriele Massimetti, Elisa Schiavi, Lionella Palego 和 Mario Catena-Dell’Osso 目的 本研究中，我们探讨氟伏沙明血浆浓度与成人强迫症（OCD）患者（采用该药物治疗6个月）的临床特征和/或缓解之间可能的关系。 方法 本研究共纳入20例已采用氟伏沙明（平均剂量±SD：216.7±86.2）治疗至少4周的OCD门诊男女患者。采用Yale—Brown强迫症量表（Y-BOCS）评估OCD的严重程度。采用高效液相色谱法分析法测定氟伏沙明血浆浓度。所有评定均在服用氟伏沙明4周（t1）和6个月（t2）后进行。 结果 氟伏沙明血浆浓度在两个评估时间点保持稳定，无性别差异。16例患者（80%）经治疗后缓解，表现为Y-BOCS总分显著降低（35%）。男性强迫行为的改善程度大于女性。t1和t2时氟伏沙明血浆浓度与t1和t2之间Y-BOCS总分和强迫行为分量表评分的差值（△）之间检测到显著正相关。另一个显著性关联为（尽管是负相关），强迫行为分量表评分差值与t1和t2时氟伏沙明浓度差值之间检测到相关性。 结论 研究结果表明评价OCD患者的氟伏沙明血浆浓度，及其与对具体症状可能与性别有关的临床缓解之间关系的潜在重要性。 关键词:氟伏沙明；强迫症；血浆浓度；药物代谢；HPLC；Y-BOCS Plasma fluvoxamine levels and OCD symptoms/response in adult patients Donatella Marazziti*, Stefano Baroni, Gino Giannaccini, Armando Piccinni, Michela Picchetti, Gabriele Massimetti, Elisa Schiavi, Lionella Palego and Mario Catena-Dell’Osso Objective: In this study, we explored the possible relationships between plasma fluvoxamine levels and clinical features and/or response inadult obsessive–compulsive disorder (OCD) patients treated with this drug for 6 months. Methods : Twenty OCD outpatients of both sexes who were already taking fluvoxamine (mean dose_SD: 216.7 _86.2) for at least 4 weeks were included in the study. The severity of OCD was assessed by means of the Yale–Brown obsessive–compulsive scale (Y-BOCS). The fluvoxamine plasma levels were measured by high-performance liquid chromatography analysis. All evaluations were performed after 4 weeks (t1) and 6 months (t2) of fluvoxamine intake. Results: The plasma levels of fluvoxamine remained stable at the two assessment times, with no sex-related differences. Sixteen (80%) patients responded to treatment as shown by the significant (35%) decrease of the Y-BOCS total score. Men’s compulsions improved more than those of women. Significant and positive correlations were detected between fluvoxamine plasma levels at t1 and t2 and the