癫痫患者丙戊酸血药浓度监测结果及影响因素分析

目的：分析和探讨丙戊酸血药浓度监测结果及影响因素。方法：采用荧光偏振免疫法测定276例癫痫患者的丙戊酸血药浓度并分析结果。结果：71.7%患者的血药浓度结果在参考范围内;缓释片浓度明显高于常规剂型浓度（P〈0.01）;药物不良反应的发生与药物浓度相关;影响丙戊酸血药浓度的因素包括：患者病理生理因素;药物剂型与制剂质量;患者依从性;采样时间与方法;监测时间;合并用药;医嘱执行准确度和药师参与临床用药等。结论：在丙戊酸治疗药物监测中,要关注影响丙戊酸血药浓度的因素,确保患者用药安全有效。

Analysis of the monitoring results and the influencing factors of blood concentration of valproate in patients with epilepsy

AIM：To analyse and investigate the monitoring results and influencing factors of blood concentration of valproate in patients with epilepsy. METHODS：The serum concentrations of valproate in 276 patients were determined by fluorescence polarization immunoassay and the results were analyzed.RESULTS：71.7% of the results of blood drug concentration were in the reference range.The concentration of the sustained-release tablets was significantly higher than the conventional dosage forms（P0.01）.The occurrence of adverse drug reactions was associated with the drug concentration.The influencing factors of valproate concentration including physiological and pathological factors in patients,dosage forms and the quality of preparation,patient compliance,sampling time and method,monitoring time,combination therapy,the accuracy of medical order execution and involvement of pharmacists in clinical medicine therapy,etc.CONCLUSION：In therapeutic drug monitoring of valproate,it should be concerned about the impact factors of valproate concentration to ensure the safety and efficacy in patients.