艾司西酞普兰血药浓度/ 剂量比的影响因素研究.

OBJECTIVE: To investigate the influencing factors of serum concentration to dose ratio (C/ D) of escitalopram in inpatients, so as to provide basis for clinical rational drug use. METHODS: Monitoring data of serum concentration from 275 inpatients treated with escitalopram from Oct. 2019 to Nov. 2021 were collected and retrospectively analyzed by using SPSS 25. 0 statistical software. RESULTS: According to multiple linear regression analysis, only metabolism type of metabolic enzyme CYP2C19 and daily dose could explain the significant changes in the serum concentration of escitalopram. The C/ D of escitalopram in inpatients was significantly higher in the female group than in the male group (P = 0. 021<0. 05). In terms of drug combination, significant differences in the C/ D were detected between the groups of escitalopram combined with risperidone and combined with clozapine (P =0. 035< 0. 05), escitalopram combined with propranolol and combined with omeprazole (P =0. 030<0. 05), and escitalopram combined with propranolol and combined with clozapine (P = 0. 021 < 0. 05). Moreover, there were statistically significant differences in C/ D values among the slow, fast and intermediate metabolism types of metabolic enzyme CYP2C19 (P < 0. 05). Other factors such as age, manufacturer, other drug combination and metabolic enzyme CYP2D6, had no relation with the C/ D value of escitalopram (P > 0. 05). CONCLUSIONS: The C/ D value of escitalopram is related to gender, partial drug combination and CYP2C19 genotyping, and clinical monitoring of therapeutic drugs can be enhanced to optimize dosing regimens in combination with blood levels, genotyping, clinical outcomes and pharmacoeconomics. [ABSTRACT FROM AUTHOR]