摘要
目的：研究癫痫患者丙戊酸血清浓度监测结果,为临床合理用药提供参考。方法：采用荧光偏振免疫法检测癫痫患者丙戊酸血清浓度,分析性别、年龄、合并用药对丙戊酸血清浓度的影响及丙戊酸血清浓度与疗效的关系。结果：性别差异可能并不是丙戊酸血清浓度的影响因素。丙戊酸血清浓度与患者年龄呈负相关,0-18岁组丙戊酸血清浓度为（66.12±28.08）μg/ml,明显高于19-59岁和60岁以上年龄组的（57.53±29.85）、（51.72±22.60）μg/ml,差异有统计学意义（P〈0.05）,且在不同浓度范围内分布差异亦有统计学意义（P〈0.05）。丙戊酸血清浓度与疗效存在明显关联性,联合治疗组丙戊酸血清浓度为（41.35±19.89）μg/ml,明显低于单药治疗组（65.93±26.58）μg/ml,且2组在不同浓度范围内分布差异亦有统计学意义（P〈0.05）。461例次丙戊酸血清浓度监测中,266例次（占57.70%）位于50-100μg/ml,152例次（占32.97%）和43例次（占9.33%）丙戊酸血清浓度分别〈50μg/ml和〉100μg/ml;丙戊酸血清浓度位于50-100μg/ml癫痫治疗有效率90.60%（241/266）,明显高于〈50μg/ml的33.55%（51/152）,明显高于〉100μg/ml的76.74%（33/43）,差异均有统计学有意义（P〈0.05）,说明丙戊酸血清浓度与疗效存在明显关联性。结论：丙戊酸血清浓度监测为癫痫个体化用药方案的制定提供客观依据。
OBJECTIVE： To study the monitoring results of the serum concentration of valproic acid（ VPA） in patients with epilepsy,and to provide reference for the rational use of drug in clinic. METHODS： The serum concentration of VPA was determined by the fluorescence polarization immunoassay; the effects of gender,age and drug combination on the serum concentration of VPA,as well as the correlation between the serum concentration of VPA and clinic efficacy were analyzed. RESULTS： Gender differences might not be the influence factors of serum concentrations of valproic acid. The serum concentration of VPA and the patients＇ age showed the negative correlation. And the serum concentration of VPA in 0-18 year-old group were（ 66. 12 ± 28. 08） μg / ml,which were significantly higher than that in19-59 year-old group（ 57. 53 ± 29. 85） μg / ml and over 60 year-old group（ 51. 72 ± 22. 60） μg / ml,with statistically significant difference（ P 〈0. 05）; and there were also significant difference in the distributions of different ranges of concentration（ P 〈0. 05）. There were obvious correlation between serum concentration of VPA and efficacy. The serum concentration of VPA in combination therapy group was（ 41. 35 ± 19. 89） μg / ml,significantly higher than that in single therapy group（ 65. 93 ± 26. 58） μg / ml,and there were significant difference in the distributions of different ranges of concentration in two groups（ P 〈0. 05）. Among 461 cases with monitoring of serum concentration of VPA,266 cases（ 57. 70%） were in 50 - 100 μg /ml,and 152 cases（ 32. 97%） and 43 cases（ 9. 33%） were respectively 50 μg /ml and 100 μg / ml. The effective rate of epilepsy treatment in range of 50 - 100 μg / ml of serum concentration of VPA was90. 60%（ 241 /266）,significantly higher than that in range of 50 μg / ml 33. 55%（ 51 /152） and 100 μg / ml 76. 74%（ 33 /43）,with statistically significant difference（ P 〈0. 05）; which showed that there were significant correlation between the serum concentration of VPA and clinic efficacy. CONCLUSIONS： Monitoring of the serum concentration of VPA can provide objective evidence for formulating individualized therapeutic regimen in patients with epilepsy.
出处
《中国医院用药评价与分析》
2015年第12期1613-1616,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
丙戊酸
血清浓度
治疗药物监测
个体化用药
癫痫
Valproic acid
Serum concentration
Monitoring of therapeutic drug
Individualized medication
Epilepsy
