丙戊酸钠血药浓度及达标率的影响因素分析

doi:10.19803/j.1672-8629.20260322

摘要/Abstract

摘要： 目的分析某三甲医院住院患者丙戊酸钠血药浓度监测结果,探究其血药浓度及达标率的影响因素,为临床合理用药提供参考。方法回顾性分析河南理工大学第一附属医院2021年10月20日至2026年3月26日住院患者丙戊酸钠的血药浓度监测结果,其检测方法均为荧光免疫层析法,共收集有效数据137例。计算住院患者丙戊酸钠血药浓度的达标率及不良反应发生率,并探讨患者性别、年龄、肝功能、抽烟史、饮酒史、合并疾病、剂型、日剂量及合并用药对血药浓度及达标率的影响。结果 137例住院患者丙戊酸钠血药浓度平均值为（60.38±36.80）μg·mL^-1,达标率为44.52%。不良反应发生率为13.87%,血药浓度>100 μg·mL^-1和使用注射剂时不良反应发生率显著增加。多元线性回归分析结果显示日剂量、注射剂、合用碳青霉烯类药物和肝药酶诱导剂是丙戊酸钠血药浓度的独立影响因素,具有统计学意义（P<0.05）。二元Logistic回归分析结果显示肝功能是丙戊酸钠血药浓度达标率的独立影响因素（OR=8.349,95%CI：1.752~39.772,P=0.008）。结论临床应用丙戊酸钠时应重点关注患者肝功能、日剂量、剂型、合用碳青霉烯类药物和肝药酶诱导剂。通过监测丙戊酸钠血药浓度,可为临床合理用药提供参考。

关键词: 丙戊酸钠, 血药浓度, 达标率, 荧光免疫层析法, 影响因素

Abstract: Objective To analyze the blood concentrations of sodium valproate in inpatients at a hospital and explore the determinants of blood concentrations and therapeutic target attainment so as to provide references for rational use of sodium valproate. Methods This study was a retrospective study. The concentrations of sodium valproate in patients hospitalized at the First Affiliated Hospital of Henan Polytechnic University between October 20, 2021 and March 26, 2026 were analyzed. All the samples were detected via fluorescent immunochromatographic assay and a total of 137 valid cases were collected. The therapeutic target attainment rate of blood concentrations and the incidence of adverse drug reactions (ADRs) in these patients were calculated while the effects of gender, age, liver function, smoking history, drinking history, comorbidities, dosage forms, daily dose, and concomitant medications on blood concentrations and the target attainment rate were explored. Results The mean blood concentration of sodium valproate among the 137 inpatients was (60.38±36.80) μg·mL^-1, and the target attainment rate was 44.52%. The incidence of ADRs was 13.87%. Notably, the incidence of ADRs was significantly higher among patients with blood concentrations above 100 μg·mL^-1 and those treated with injection. Multiple linear regression analysis showed that daily dose, injection, concomitant carbapenems and hepatic enzyme inducers were independent factors influencing blood concentrations, with statistically significant difference (P<0.05). Binary logistic regression analysis suggested that liver function was an independent influencing factor of the target attainment rate of blood concentrations (OR=8.349, 95%CI: 1.752-39.772, P=0.008). Conclusion Clinicians should closely monitor patients’ liver function, daily dose, and dosage forms, as well as concomitant use of carbapenems and hepatic enzyme inducers when administering sodium valproate. Monitoring blood concentrations of sodium valproate can provide references for its rational clinical administration.

Key words: Sodium Valproate, Blood Concentrations, Target Attainment Rate, Fluorescent Immunochromatographic Assay, Influencing Factors

中图分类号:

杨航, 刘婷, 赵岩, 王秀丽. 丙戊酸钠血药浓度及达标率的影响因素分析[J]. 中国药物警戒, 2026, 23(8): 919-925.

Yang Hang, Liu Ting, Zhao Yan, Wang Xiuli. Determinants of blood concentrations and target attainment rates of sodium valproate[J]. Chinese Journal of Pharmacovigilance, 2026, 23(8): 919-925.

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