卡马西平治疗癫血药浓度监测及合理用药

目的探讨卡马西平抗癫作用与血药浓度的关系,以指导临床合理用药。方法采用萤光偏振免疫法(FPIA)测定128例癫患者卡马西平的血药浓度。结果血药浓度在有效治疗范围且癫发作得以基本控制的占82.56%,25.00%的患者血药浓度低于有效治疗范围而癫发作仍得到有效控制,其中联合用药中42.86%的患者癫发作得以控制。结论血药浓度监测有利于提高癫治疗药物的安全性、有效性及合理性,减少毒副作用,但需考虑一些影响因素,如卡马西平肝药酶诱导作用,代谢物卡马西平10,11-环氧化物对临床疗效的影响,药物相互作用,以及给药方案等。

Monitoring of plasma concentration of carbamazepine in epileptic patients

Objective To investigate the relationship between antiepeleptic actions and plasma concentration of carbamazepine(CBZ)in epileptic patients,and provide some references for clinical uses.Methods The plasma CBZ concentrations of 128 patients with epilepsy were analyzed by fluorescence polarization immunoassy(FPIA).Results 82.56% of the patients with plasma concentration of CBZ in effective range had their epileptic attrack controlled,25.00% of patients with blood levels of drug under effective range,42.86% of patients receiving combined drug therapy also had their epileptic attack controlled.Conclusion Drug plasma concentration monitoring is useful in improving safety,availability and rationality for epileptic drugs clinically.But it is neccessary to consider some influencing factors:the drug metabolism enzyme inducing effect;the metabolites of CBZ10,11-cycloxide which might influencing the effect;the interaction of drugs,the methods of drug administration.