| 摘要: |
| 目的:分析癫痫患儿丙戊酸(VPA)血药浓度监测结果,为临床个体化用药提供参考。方法:采用均相酶放大免疫法测定720例癫痫患儿丙戊酸血药浓度并分析结果。结果:VPA有效血药浓度范围为40~100 μg/mL,VPA高于有效血药浓度时总有效率明显降低,不良反应发生率明显增高(P均<0.01)。单用VPA 的患儿中,<3岁组低于有效血药浓度的患儿比例较高,7~16岁组高于有效血药浓度的患儿比例较高(P均<0.01);口服溶液组低于有效血药浓度的患儿比例较高,普通片剂组高于有效血药浓度的患儿比例较高(P均<0.01)。联用其他抗癫痫药物的患儿(联用组)总有效率74.85%,低于单用VPA(单用组)的
89.24%,且联用组VPA血药浓度高于有效血药浓度的患儿比例高于单用组(29.34% vs 9.36%,P均<0.01)。结论:VPA的临床疗效、不良反应与血药浓度密切相关,但血药浓度受多种因素影响(年龄、剂型、联合用药等),临床上个体化给药时不能仅以血药浓度监测结果为依据,应综合考虑以确保患儿用药的安全有效。 |
| 关键词: 丙戊酸 血药浓度监测 个体化用药 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2017.10.013 |
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| 基金项目: |
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| Serum Concentration Monitoring of Valproic Acid in 720 Cases of Epileptic Children |
| Zhao Guozhen, Xu Jing, Jing Xia |
| (Children's Hospital of Nanjing Medical University, Jiangsu Nanjing 210008, China) |
| Abstract: |
| Objective: To analyze the monitoring results of the serum concentration of valproic acid (VPAS) in epileptic children in order to provide reference for individualized therapy of clinical. Methods: The serum concentrations of VPA of 720 cases were determined by enzyme-multiplied immunoassay technique, the results were analyzed. Results: The effective serum concentration range of VPA was 40~100 μg/mL. The total effective rate was obviously reduced and the incidence of adverse reactions was obviously
increased when the serum concentration was higher than effective rage (P<0.01). Among the children which were treated with VPA only, the percentage of children whose serum concentrations were lower than effective range was higher than others in under 3 years old group, the percentage of children whose serum concentrations were higher than effective range was higher than others in 7 to 16 years old group. The percentage of children whose serum concentrations were lower than effective range was higher than others in oral solution group, the percentage of children whose serum concentrations were higher than effective range was higher than others in tablet group. The total effective rate of children who was given VPA combined with other antiepileptic drugs was 74.85%, which was lower than VPA only (89.24%). The percentage of children whose serum concentrations were higher than effective range in drug combination group was higher than single drug group (29.34% vs. 9.36%, P<0.01). Conclusion: The serum concentration of valproic acid was influenced by many factors. We must comprehensively consider, but not based solely on the drug concentration in serum, the administration of oral valproic acid to epileptic patients so as to ensure the safety and effectiveness of drug use. |
| Key words: valproic acid serum concentration monitoring individualized administration |
