拉莫三嗪治疗癫痫的剂量及血药浓度

目的:研究拉莫三嗪治疗癫痫的有效血药浓度、剂量与疗效三者之间关系以及和/或丙戊酸等其它抗癫痫药合用时的相互影响。方法:83例患者分为3组,即拉莫三嗪组、拉莫三嗪+丙戊酸组及拉莫三嗪+丙戊酸+其它抗癫痫药组。拉莫三嗪的起始剂量拉莫三嗪组为2mg/(kg·d),联合用药组为0.2mg/(kg·d),丙戊酸成人起始剂量为负荷量。结果:联合用药组中的部分病例拉莫三嗪剂量高于国外推荐剂量。当拉莫三嗪剂量在2～7mg/kg、血药浓度在1～6mg/L,丙戊酸的剂量在4～28.19mg/kg、血药浓度在37.46～113.79mg/L时,癫痫有效控制率在67.6％～86.4％之间。结论:国外推荐的拉莫三嗪有效血药浓度及与其它抗癫痫药合用时的剂量可能偏低。

Dosage and Serum Concentration of Lamotrigine in Treating Epilepsy

OBJECTIVE: To study the relationship between effective serum concentration, dosage and effect of Lamotrigine (LTG) in treating epilepsy and/or interrelationship between LTG and Valproate(VPA) .METHODS: 83 cases were divided into 3 groups, LTG, LTG + VPA and LTG + VPA + other AEDs .Beginning dose of LTG was 2mg/(kg·d) in LTG group; that was 0.2mg/(kg·d) in combined -- drug groups; beginning dose of VPA was loading dose. RESULTS: In part of cases in combined - drug groups, the dosage of LTG was larger than that recommended by foreign literature. In dosage of 2～7mg/kg LTG, serum concentration of 1～6mg/L LTG, dosages of 4～28.19mg/kg VPA and serum concentration of VPA 37.46～1l3.79mg/L, the effectively controlled rate of epilepsy attack was between 67.6% and 86.4% .CONCLUSION: The recommended effective serum concentration and dosages of LTG in combined use with other AEDs seem to be lower than they should be.