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目的:探讨吸烟与精神分裂症患者抗精神病药物效果的相关性。方法:选取2017年7月至2019年7月于衢州市第三医院住院治疗的精神分裂症患者142例，均采用奥氮平治疗，并计算血清药物浓度和浓度/剂量比(C/D)。收集两组年龄、性别、肝功能、吸烟、合并用药等临床资料，采用多因素logistic回归分析影响精神分裂症患者奥氮平血药浓度达标的相关因素。结果:血药浓度<20 ng/mL组(不达标组)44例，20～80 ng/mL组(达标组)98例。不达标组中男性72.2%(32/44)，年龄(61.6±10.5)岁，有吸烟史90.1%，血清C/D为(2.5±1.1)ng·mLn －1·mgn －1·dn －1；达标组中男性51.0%，平均年龄(57.9±9.6)岁，存在吸烟史占41.8%(50/98)，血清C/D为(3.2±1.8)ng·mLn －1·mgn －1·dn －1；两组在性别、年龄、吸烟史、血清C/D值等方面差异均有统计学意义[χn 2(n t)＝5.86、2.06、5.43、2.38，均n P<0.05]。多因素logistic回归分析显示，与从不吸烟者相比，既往吸烟使血药浓度不达标的概率增加了11%(n OR＝1.11，n P＝0.027)，目前吸烟使血药浓度不达标的概率增加了15%(n OR＝1.15，n P＝0.001)；与CYP1A2位点基因AA相比，CYP1A2位点基因AC使血药浓度不达标的概率降低了15%(n OR＝0.85，n P＝0.001)，CYP1A2位点基因CC使血药浓度不达标的概率降低了13%(n OR＝0.87，n P＝0.002)。n 结论:精神分裂症患者吸烟与奥氮平血药浓度达标值具有独立相关性，戒烟能够降低血药浓度不达标的概率。“,”Objective:To explore the relationship between smoking and the effect of antipsychotics in schizophrenics.Methods:From July 2017 to July 2019, 142 schizophrenics in the mental health center were treated with olanzapine, and the serum drug concentration and concentration/dose ratio (C/D) were calculated.The age, sex, liver function, smoking, combined medication and other clinical data of the two groups were collected, and the influencing factors of serum olanzapine concentration in schizophrenic patients were analyzed by multivariate logistic regression.Results:Forty-four patients were in the non-compliance group(serum olanzapine concentration <20ng/mL), and 98 patients were in the compliance group(serum olanzapine concentration 20-80ng/mL). In the non-compliance group, males accounted for 72.2%, the average age was (61.6±10.5)years old, smoking history accounted for 90.1%, and serum C/D was (2.5±1.1)ng·mL n -1·mgn -1·dn -1, and in the compliance group, males accounted for 51.0%, the average age was (57.9±9.6)years old, smoking history accounted for 41.8%, and serum C/D was (3.2±1.8)ng·mLn -1·mgn -1·dn -1, and there were statistically significant differences in sex, age, smoking history and serum C/D between the two groups (n t=5.86, χ n 2=2.06, χ n 2=5.43, n t=2.38, all n P<0.05). Multivariate logistic regression analysis showed that smoking and CYP1A2 genes were independently related to whether the plasma concentration of olanzapine was up to standard in schizophrenic patients.Compared with non-smokers, previous smoking increased the probability of blood concentration non-compliance by 11% and current smoking by 15% respectively(n OR=1.15, n P=0.001). And compared with CYP1A2 gene AA, CYP1A2 gene AC reduced the probability of blood concentration non-compliance by 15% and CYP1A2 gene CC by 13%(n OR=0.87, n P=0.002).n Conclusion:There is an independent correlation between smoking and serum C/D value of olanzapine in schizophrenics.Quitting smoking can reduce the probability of substandard blood concentration.