| 摘要: |
| 目的：探讨丙戊酸治疗小儿癫痫的效果及影响血药浓度的因素分析。方法：回顾性分析2014年7月至2017年7月三家三甲医院儿科使用丙戊酸进行治疗的癫痫患儿312例。所有患儿均进行CYP2C19基因多态性检测，确定患儿的CYP2C19的基因类型。口服丙戊酸治疗10 d，待血药浓度稳定后进行血药浓度检测。结果：患儿治疗后显效125例（40.06%），有效138例（44.23%），总有效率为84.29%；平均血药浓度（44.59±27.60）μg/mL。6~11岁患儿平均血药浓度[（84.33±22.56）μg/mL]高于其他年龄段患儿。基因型EM的患儿144例（46.15%），基因型IM的患儿70例（22.43%），基因型PM（弱代谢）患儿98例（31.41%）。<3岁EM患儿血药浓度最低[（26.31±13.22）μg/mL]，6~11岁PM患儿的血药浓度最高[（96.31±34.25）μg/mL]。结论：小儿癫痫使用丙戊酸治疗有效率84.29%，可以根据患儿的年龄和基因类型，合理调整治疗方案，达到最佳的治疗效果。 |
| 关键词: 小儿癫痫 丙戊酸 血药浓度 基因多态性 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2019.01.006 |
|
| 基金项目: |
|
| Effect of Valproic Acid on Children’s Epilepsy and Blood Concentration Influencing Factors |
| Cao Jianwei1, Xiao Huimei2, Zeng Xiangdong3, Liu Meiling1, Li Yingying1 |
| (1.Zhongshan People’s Hospital, Guangdong Zhongshan 528400, China; 2. Guangdong Maternal and Child Health Hospital, Guangdong Guangzhou 510010, China; 3. Chengdu Women and Children’s Central Hospital, Sichuan Chengdu 610031, China) |
| Abstract: |
| Objective: To investigate the effect of valproic acid on pediatric epilepsy and the factors influencing the plasma concentration. Methods: A total of 312 children with pediatric epilepsy were treated retrospectively in 3 top three hospitals from 2014.7~2017.4.All patients The CYP2C19 gene polymorphism was detected and the genotype of CYP2C19 was determined. Then they were treated with valproic acid. After 5 days of treatment, the plasma concentration was determined. Results: 125 cases (40.06%) were significant effective, 138 cases (44.23%) were effective, the total effective rate was 84.29%, and the average blood concentration was 44.59±27.60μg/ml. The average plasma concentration of children aged 6-11 years (84.33±22.56 μg/mL) was higher than other age groups. There were 144 children (46.15%) with genotype EM, 97cases (31.09%) children with genotype IM and 70 (22.43%) children with genotype PM. The average blood concentration of EM children (<3 years old) was 26.31±13.22 μg/mL, and average blood concentration of PM children (6-11 years old) was 96.31±34.25 μg/mL. Conclusion: The effective rate of valproic acid treatment in children with epilepsy is 84.29%. According to children's age and genotype, reasonable adjustment of treatment options to achieve the best therapeutic effect. |
| Key words: pediatric epilepsy VPA plasma concentration gene polymorphism |
