一线抗癫癎药物血药浓度监测结果分析

目的:对一线抗癫癎药物血药浓度监测结果进行回顾性分析,指导临床合理用药。方法:对801例服用一线抗癫癎药物病人的血药浓度进行分类汇总,并对结果进行统计学分析。结果:各药在有效血药浓度范围内的病例百分率差异显著(P<0.01),分别为丙戊酸钠(VPA)75.2%、苯巴比妥(PB)67.3%、卡马西平(CBZ)53.1%、苯妥英钠(PHT)20.8%。VPA使用率最高,为60.5%,其血药浓度存在性别差异(P<0.01)。CBZ血药浓度存在年龄差异(P<0.01)。多药联用血药浓度升高的病例增加(P<0.01),以PHT/CBZ方案最为突出。CBZ/VPA、PB/VPA方案在控制率、安全性方面比较好。结论:血药浓度监测对癫癎治疗具有极其重要的临床意义。

Analysis of results of monitoring the serum concentrations of first-line antiepileptics

Objective: To analyze the results of monitoring serum concentrations of first-line antiepileptics for guiding the rational use of first-line antiepileptics in clinical practice. Methods: The serum drug concentrations of 801 epileptic patients taking first-line antiepileptics were collectd and sorted. The results were analyzed. Results: The percentages of patients with serum drug concentrations within the effective ranges after single first-line antiepileptic treatment were significantly different (P<0.01), with sodium valproate (VPA), phenobarbital (PB), carbamazepine (CBZ) and sodium phenytoin(PHT) being 75.2%,67.3% ,53.1% and 20.8% , respectively. The rate of use of VPA was the highest (60. 5%), and its serum concentrations had significant sex difference (P<0.01). The serum concentrations of CBZ had significant age difference (P<0.01). The serum drug concentrations of patients treated with combination of drugs were significantly higher than those treated with single antiepileptic (P<0.01), especially PHT/CBZ regimen. CBZ/VPA and PB/VPA regimens were good in control rate and safety. Conclusion: This study indicates that it is very important to monitor serum drug concentrations for epilepsy therapy.