本文应用基于meta分析的群体药动学研究方法分析利培酮及其代谢产物的群体药物动力学特征。文中首先筛选发表于1995至2011年的文献,得到18篇符合录入排除标准的文献,并在文献数据的基础上建立了利培酮及其活性代谢产物9-羟基利培酮的群体药动学模型。建立的模型用二室模型描述原药利培酮体内过程,一室模型描述活性代谢产物9-羟基利培酮的体内过程,并在药物的吸收过程中加入了原药的首过代谢过程。模型得到原药和代谢产物的系统清除率分别为7.66 L/h和7.38 L/h,表观分布体积分别为70.6 L和117 L。建立的模型通过1000次仿真的可视化检验评价模型的拟合程度。本文还利用42例精神分裂症患者临床治疗药物监测数据来评价模型对于中国患者人群中利培酮血药浓度的预测性。本研究证明通过文献数据所建的模型是可靠的,可以用作目标群体个体化治疗的依据。
Population pharmacokinetic meta-analysis method was used in order to obtain the pharmacokinetic characteristics of risperidone and its active metabolite. Eighteen studies were selected from published papers from 1995 to 2011. A model consisted of two compartments for parent drug and one compartment for its active metabolite combined with a flexible absorption process was developed based on the meta-dataset. The population-predicted apparent clearance for risperidone and 9-hydroxyrisperidone, the active metabolite was 7.66 L/h and 7.38 L/h, and the apparent volume of distribution in the central compartment was 70.6 L and 117 L, respectively. The final model was evaluated by visual predictive check(VPC) based on 1000 times model simulation. This model was adequately used to predict clinical therapeutic drug monitoring(TDM) data from 42 Chinese inpatients. Bias(mean prediction errors, MPE) and precision(root mean squared prediction errors, RMSE) were calculated to statistically analysis the population prediction error. It was demonstrated that the model developed from the meta-dataset was reliable and can be used to facilitate the individualized treatment for a target population.