经期性癫痫苯妥英血药浓度及药动学的周期性变化

目的:探讨经期性癫痫在月经周期苯妥英血药浓度及药动学的变化。方法:收集9例应用苯妥英的经期性癫痫,在连续3个月经周期中采用高效液相色谱法分别测定月经期和排卵期苯妥英血药浓度,并选择其中3例进行药动学研究。结果:月经期与排卵期的苯妥英平均血药浓度分别为(9·25±2·71)、(13·33±3·22)μg/ml(P<0·01);苯妥英月经期消除速率大于排卵期,月经期消除半衰期短于排卵期。结论:经期性癫痫月经期苯妥英血药浓度降低可能与其清除能力增强有关。

Cyclical Variations of Blood Concentration of Phenytoin and Its Pharmacokinetics in Menstrual Epilepsy

OBJECTIVE:To explore the changes of serum phenytoin levels and its pharmacokinetics in menstrual epilepsy.METHODS:9cases of menstrual epilepsy patients who were treated with phenytoin were collected,whose blood concentraˉtions of phenytoin in menstrual period and ovulation period were respectively determined by HPLC,pharmacokinetics study was performed in three of them.RESULTS:The mean serum phenytoin levels in menstrual period and ovulation period were(9.25±2.71)μg/ml and(13.33±3.22)μg/ml,respectively(P<0.01);The elimination rate of phenytoin in menstrual period was above that in ovulation period,the elimination half life of phenytoin in menstrual period was shorter than that of the ovulation period.CONCLUSION:The decreased serum phenytoin level during the menstruation of the menstrual epilepsy may be related to its increased elimination power.