不同丙戊酸盐和丙戊酸剂型对丙戊酸血药浓度的影响

目的：研究不同丙戊酸盐和丙戊酸剂型对丙戊酸血药浓度的影响。方法：回顾性分析某院270例丙戊酸血药浓度监测报告，记录患者姓名、年龄、体质量、丙戊酸的用法与用量、联合用药情况（合用药品及其用法与用量）和血药浓度监测结果。分析不同丙戊酸盐和丙戊酸剂型对丙戊酸标准血药浓度的影响。结果：二元Logistic回归分析结果表明丙戊酸盐类型和剂型对标准血药浓度有显著影响（P<0.05）；丙戊酸镁的标准血药浓度（9.18±3.54）μg·kg·mL^-1·mg^-1]大于丙戊酸钠盐的标准血药浓度（6.76±2.54）μg·kg·mL^-1·mg^-1]；丙戊酸缓释片的标准血药浓度（8.38±3.49）μg·kg·mL^-1·mg^-1]大于丙戊酸普通片的标准血药浓度（6.88±2.54）μg·kg·mL^-1·mg^-1]，差异均具有显著性（P<0.05）。结论：不同丙戊酸盐和丙戊酸剂型对丙戊酸血药浓度存在明显影响，如何选择丙戊酸盐和丙戊酸剂型对丙戊酸的合理运用具有重要意义。

Effects of different valproate and valproic acid dosage forms on plasma concentration of valproic acid

OBJECTIVE To evaluate the effects of different valproate and valproic acid dosage forms on the plasma concentration of valproic acid.METHODS Totally 270 cases of valproic acid blood concentration monitoring reports in our hospital were retrospectively analyzed. All patient name, age, weight, usage and dosage of valproic acid, combined use of drugs (combined drug and usage and dosage) and blood concentration monitoring results were recorded. The effects of different valproate and valproic acid dosage forms on the standard blood concentration of valproic acid were analyzed.RESULTS The logistic regression analysis showed that valproate type and dosage form had significant effect on the standard blood concentration (P<0.05). The standard blood concentration of magnesium valproate (9.18±3.54 μg·kg mL^-1·mg^-1) was greater than that of valproate sodium (6.76±2.54 μg·kg mL^-1·mg^-1). The standard blood concentration of the sustained release tablets of valproic acid (8.38±3.49 μg·kg mL^-1·mg^-1) was significantly higher than that of the standard valproic acid tablets (6.88±2.54 μg·kg mL^-1·mg^-1) (P<0.05).CONCLUSION Different valproate and valproic acid formulations have significant effects on valproic acid plasma concentration. The choice of valproate and valproic acid dosage forms has great importance to the rational use of valproic acid.