目的探讨客体关系自主同一性量表(mutuality of autonomy scale,MOA)在评估精神疾病疗效中的作用。方法符合入组标准的32例分裂症(偏执型)、30例抑郁症(单相),两组患者治疗前后经罗夏测验、MOA量表、PANSS量表(阳性症状与阴性症状量表)、汉密尔顿抑郁量表评分。结果罗夏自主同一性量表与PANSS及汉密尔顿量表之间均有较好的相关;分裂症在高客体关系水平上差异显著,抑郁症在高、低客体关系水平上差异均显著;治疗前后,分裂症组的SA(分离、自主的相似活动)是显著升高,抑郁症SI(分离、自主的相互作用)显著升高,而DI(毁灭性不平衡)显著降低,这些指标或许可作为评估分裂症及抑郁症疗效的标志。结论客体关系自主同一性量表(MOA)部分指标能有效地评估精神疾病疗效。
Aim To develop and validate a sensitive and specific liquid chromatography electrospray ionization ion-trap mass spectrometry （LC-ESI-MS/MS） method for the identification and concentration of rupatadine in human plasma. Methods After the addition of the internal standard （IS, loratadine） and 0.01 mol·L^-1 sodium hydroxide solution, plasma samples were extracted with methylene chloride： ethyl acetate mixture （20：80, V/V）. The organic layer was evaporated under vacuum drying at 37 ℃. The residue was reconstituted with 200 μL mobile phase. Chromatography was performed on an Agilent Eclipse XDB-C18 （4.6 mm × 150 mm, 5 μm） column with a mobile phase consisting of acetonitrile （1% formic acid） -20 mmol·L^-1 ammonium acetate （76：24, V/V） at a flow-rate of 0.6 mL·min^-1. Detection was performed on Agilent MSD Trap XCT ion-trap mass spectrometry connected to a Agilent 1100 high performance liquid chromatography （HPLC） by selected reaction monitoring （SRM） mode via electrospray ionization （ESI） source. Rupatadine （MRM m/z 416 → 309） and loratadine （MRM m/z 383 → 337） were detected by Agilent MSD Trap XCT ion-trap mass analyser. Results The method was proved to be sensitive and specific by testing 20 different plasma batches. Linearity was established for the range of concentrations 0.05 - 14.0 ng·mL^ -1 with a coefficient of determination （r） of 0.998. The intra-and inter-day precision （RSD %） were lower than 15% and accuracy ranged from 85.1% to 114.0%. The lower limit of quantitation （LLOQ） was identifiable and reproducible at 0.05 ng·mL^-1 with a precision of 9.22% （n =5）. Conclusion The proposed method is sensitive and reproducible enough to be used in pharmacokinetic, bioavailability or bioequivalence studies of rupatadine.
