中国药物警戒 ›› 2026, Vol. 23 ›› Issue (4): 460-463.
DOI: 10.19803/j.1672-8629.20250484

• 安全与合理用药 • 上一篇    下一篇

270例青少年患者奥氮平剂量校正浓度和体重增加的影响因素分析

彭陈陈1, 曾环思1, 张茉莉2,*   

  1. 1深圳市精神卫生中心,深圳市康宁医院,深圳市精神心理疾病临床医学研究中心,生化与药学实验室,广东 深圳 518118;
    2深圳市精神卫生中心,深圳市康宁医院药学部,深圳市精神心理疾病临床医学研究中心,广东 深圳 518118
  • 收稿日期:2025-07-21 出版日期:2026-04-15 发布日期:2026-04-15
  • 通讯作者: *张茉莉,女,学士,主管药师,临床药理学。E-mail: 524335427@qq.com
  • 作者简介:彭陈陈,男,硕士,主管药师,临床药理学。
  • 基金资助:
    广东省高水平临床重点专科（深圳市配套建设经费）资助（SZGSP013）; 深圳市科技创新局项目（20210617155253001）

Determinants of Concentration/Dose Ratio and Weight Gain of Olanzapine in Teen Patients

PENG Chenchen1, ZENG Huansi1, ZHANG Moli2,*   

  1. 1Biochemistry and Pharmacy Laboratory, Shenzhen Clinical Research Center for Mental Disorders, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen Guangdong 518118, China;
    2Department of Pharmacy, Shenzhen Clinical Research Center for Mental Disorders, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen Guangdong 518118, China
  • Received:2025-07-21 Online:2026-04-15 Published:2026-04-15

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摘要： 目的 分析奥氮平血药浓度数据,探讨青少年患者奥氮平剂量校正浓度（Concentration/Dose Ratio,C/D）和体重增加的影响因素,为青少年患者合理使用奥氮平提供参考。方法 收集深圳市康宁医院2022年1月1日至2024年12月31日进行奥氮平治疗药物监测（Therapeutic Drug Monitoring, TDM）的270例住院患者血药浓度结果和相关资料,梳理性别、体质指数（Body Mass Index, BMI）以及合并用药对血药浓度的影响,探讨体重增加的危险因素。结果 270例青少年患者中,男女比例为1∶1.57,平均年龄（15.5±1.3）岁,服药剂量为15.0（5.0,20.0）mg·d-1,浓度为37.8（23.9,56.5） ng·mL-1,C/D值为3.33（2.35,4.43） ng·mL-1·mg-1。女性患者的C/D值显著高于男性,差异具有统计学意义（P<0.05）。肥胖（BMI>24.0 kg·m-2）患者的C/D值低于正常（BMI为18.5~24.0 kg·m-2）患者,差异具有统计学意义（P<0.05）。联用丙戊酸时,奥氮平C/D值显著降低,差异具有统计学意义（P<0.05）;联用氟西汀时,奥氮平C/D值显著升高,差异具有统计学意义（P<0.05）。相较于成年人,青少年患者服用奥氮平导致体重增加更常见。Logistic回归分析表明,BMI、C/D值和合并抗抑郁药是体重增加的保护因素。结论 性别、BMI、联用丙戊酸和氟西汀对奥氮平C/D值影响显著。另外,BMI、C/D值及合并抗抑郁药是体重增加的影响因素。

关键词: 奥氮平, 丙戊酸, 氟西汀, 治疗药物监测, 剂量校正浓度, 体重增加

Abstract: Objective To investigate the contributors to the olanzapine concentration/dose (C/D) ratio and weight gain among teen patients by analyzing serum concentrations of olanzapine in order to provide a reference for rational use of olanzapine in teenagers. Methods Serum concentrations and associated clinical results of olanzapine were collected from the therapeutic drug monitoring (TDM) data of 270 inpatients treated with olanzapine at Shenzhen Kangning Hospital between 2020 and 2024. The effects of gender, body mass index (BMI) and comedications on olanzapine concentrations were analyzed while risk factors for weight gain were explored. Results Among the 270 teen patients, the ratio of males to females was 1∶1.57, and the average age was (15.5±1.3) years, the daily dose of olanzapine was 15.0 (5.0, 20.0) mg·d-1, the serum concentration was 37.8 (23.9, 56.5) ng·mL-1 and the C/D ratio was 3.33 (2.35, 4.43) ng·mL-1·mg-1. The C/D ratio of female patients was higher than that of male patients, with statistically significant differences (P<0.05). The C/D ratio of olanzapine in obese patients (BMI>24.0 kg·m-2) was lower than that of normal patients (BMI 18.5 to 24.0 kg·m-2),with statistically significant differences (P<0.05). The C/D ratio of patients treated with olanzapine combined with valproate was lower than that of patients who were not, with statistically significant differences (P<0.05). The C/D ratio of patients treated with olanzapine combined with fluoxetine was higher than that of patients who were not, with statistically significant differences (P<0.05). Wight gain was more prevalent in teenagers than in adults. Logistic regression analysis showed that BMI, C/D ratios and concomitant antidepressants were protective factors for weight gain. Conclusion Gender, BMI, and the combination of valproate and fluoxetine can impact the C/D ratio of olanzapine. In addition, BMI, C/D ratios and the combination of antidepressants are contributors to weight gain.

Key words: Olanzapine, Valproate, Fluoxetine, Therapeutic Drug Monitoring, Dose Corrected Concentration, Weight Gain

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