中国药物警戒 ›› 2022, Vol. 19 ›› Issue (9): 1027-1029.
DOI: 10.19803/j.1672-8629.2022.09.20

• 安全与合理用药 • 上一篇    下一篇

258例癫痫患儿丙戊酸钠的血药浓度监测及影响因素分析

寻晓庆1, 彭玲玲2   

  1. 1长沙市第一医院,湖南 长沙410000;
    2中山大学孙逸仙纪念医院,广东 广州510010
  • 收稿日期:2020-11-05 出版日期:2022-09-15 发布日期:2022-09-16
  • 作者简介:寻晓庆,女,硕士,主治医师,神经内科相关研究。
  • 基金资助:
    2019广东省医学科学技术研究基金项目（B2019031）

Effects of sodium valproate on children with epilepsy and determinants of blood concentrations

XUN Xiaoqing1, PENG Lingling2   

  1. 1The First Hospital of Changsha, Changsha Hunan 410000, China;
    2Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510010, China
  • Received:2020-11-05 Online:2022-09-15 Published:2022-09-16

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摘要： 目的 探讨血药浓度监测对丙戊酸钠（VPA）治疗癫痫患儿的作用,为临床药物治疗提供参考。方法 回顾性纳入某院2018年1月1日至2019年12月31日期间258例单药使用丙戊酸治疗的癫痫患儿,收集个人资料、记录VPA血药浓度、药物疗效及药品不良反应。采用多重线性回归分析多种因素对血药浓度的影响。结果 159例(61.63%)在50~100 μg·mL-1范围,90例(34.88%)血药浓度<50 μg·mL-1,9例(3.45%)血药浓度>100 μg·mL-1。血药浓度>100 μg·mL-1中有效率最高（100%）,与<50 μg·mL-1组比较差异具有统计学意义（P=0.025）。血药浓度>100 μg·mL-1组中不良反应发生率最高（69.39%）,与其他血药浓度组比较差异具有统计学意义(P<0.05)。多重线性回归分析发现年龄、剂型、剂量、白蛋白对VPA血药浓度结果差异有统计学意义(P<0.05)。结论 丙戊酸钠浓度个体差异较大,影响因素较多。监测其血药浓度对提高临床疗效、减少不良反应有重要意义。

关键词: 丙戊酸钠, 血药浓度监测, 影响因素, 癫痫, 儿童

Abstract: Objective To explore the effect of blood concentration monitoring on children with epilepsy treated with sodium valproate (VPA) and to provide reference for medications. Methods The clinical data on 258 patients with epilepsy treated between Jan 1, 2018 and Dec 12, 2019 was collected and analyzed retrospectively. Blood drug concentrations of VPA, drug efficacy and adverse reactions were recorded. Mutiple regression analysis was used to analyze the influence of various factors on blood drug concentrations. Results Plasma drug concentrations ranged from 50 to 100 μg·mL-1 in 159 cases (61.63%), were below 50 μg·mL-1 in 90 cases (34.88%), and above 100 μg·mL-1 in 9 cases (3.45%). The effective rate was the highest in the > 100 μg·mL-1 group, and the difference was statistically significant compared with the <50 μg·mL-1 group (P=0.025). The incidence of adverse reactions was the highest in the >100 μg·mL-1 group (69.39%), and the difference was statistically significant compared with other groups (P<0.05). Multiple linear regression analysis found that age, dosage forms, doses, and albumin could make statistically significant differences to plasma concentrations of VPA (P<0.05). Conclusion There are considerable individual differences in blood concentrations of VPA, and there are many influencing factors. Monitoring blood concentrations is of great significance for improving clinical efficacy and reducing adverse reactions.

Key words: sodium valproate, blood concentration monitoring, influencing factors, epilepsy, children

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