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为了探讨吸烟与性别对氯氮平药代动力学及稳态浓度的影响，以及氯氮平、去甲氯氮平稳态浓度与疗效、不良反应的关系，对３０例（吸烟男性１０例，不吸烟男性和女性各１０例）精神分裂症病人进行氯氮平药代动力学研究，对５８例精神分裂症病人于治疗第２、４、６、８周测定氯氮平和去甲氯氮平浓度，并评定简明精神病症状评定量表（ＢＰＲＳ）、阳性和阴性症状量表（ＳＡＰＳ、ＳＡＮＳ）及副反应量表（ＴＥＳＳ），分析血药浓度与疗效、不良反应的相关性。结果显示，吸烟者的氯氮平半衰期、达峰浓度和稳态浓度明显低于非吸烟者（Ｐ＜０．０１）。氯氮平、去甲氯氮平浓度和二者总浓度与ＴＥＳＳ呈显著正相关（Ｐ＜０．０１），与ＢＰＲＳ、ＳＡＰＳ和ＳＡＮＳ无显著相关，但有效组血药浓度高于无效组（Ｐ＜０．０５）。认为氯氮平血药浓度监测有一定临床意义，血药浓度以３５０～６００μｇ／Ｌ为宜
In order to investigate the effects of smoking and sex on clozapine pharmacokinetics and steady-state concentration, and the relationship between clozapine and norcostat concentrations, efficacy and adverse reactions, 30 patients (10 males, Non-smoking male and female 10 cases) schizophrenia patients clozapine pharmacokinetics study, 58 cases of schizophrenia patients in the treatment of 2, 4, 6, 8 weeks of determination of clozapine and norclozapine (BPRS), positive and negative symptom scales (SAPS, SANS) and adverse reaction scale (TESS) were evaluated. The correlation between plasma concentration and curative effect and adverse reactions was analyzed. The results showed that the half-life, peak concentration and steady-state concentration of clozapine in smokers were significantly lower than those in non-smokers (P <0.01). The concentrations of clozapine, norczolam and their concentrations were positively correlated with TESS (P <0.01), but not with BPRS, SAPS and SANS, but the plasma concentration of effective group was higher than that of ineffective group P <0.05). That clozapine blood concentration monitoring has some clinical significance, blood concentration to 350 ~ 600μg / L is appropriate