老年癫痫患者卡马西平、丙戊酸血药浓度监测结果分析

目的探讨老年癫痫患者卡马西平、丙戊酸血药浓度监测情况。方法对262例常规服用卡马西平、丙戊酸钠老年癫痫患者进行血药浓度监测。结果卡马西平组有13.75%低于有效血药浓度,5%高于有效血药浓度,81.25%达到有效血药浓度。而丙戊酸组有51.96%低于有效血药浓度,3.92%高于有效血药浓度,44.12%达到有效血药浓度。丙戊酸组达到有效血药浓度的比率明显低于卡马西平组（P〈0.01）,而两组高于有效血药浓度的比率基本相似（P〉0.05）。结论患者在给予卡马西平或丙戊酸钠初次使用剂量后达到有效浓度的比率存在一定差异。临床医师在应用抗癫痫药物时应实施个体化给药。

Analysis of Serum Concentration of Carbamazepine, Valproic Acid in Elderly with Epilepsy

OBJECTIVE To investigate serum concentration of carbamazepine, valproic acid in elderly patients with epilepsy. METHODS Monitored the serum concentration of carbamazepine and valproic acid in 262 patients with epilepsy. RESULTS About 13.75% patients’ blood concentration lower than the effective blood concentration, 5% higher than the effective blood concentration and 81.25% reached the effective blood concentration in carbamazepine group. About 51.96% patients’ blood concentration lower than the effective blood concentration, 3.92% higher than the effective blood concentration and 44.12% reached the effective blood concentration in valproic acid group. The results showed that the number of patients reached the effective blood concentration in valproic acid group significantly lower than that of carbamazepine group （P〈0.01）, but the number higher than the effective blood concentration in two groups was similar （P〈0.05）. CONCLUSION The two groups’ patients, who were given the initial dose of carbamazepine or sodium valproate, were different in reaching the effective concentration. The elderly patients with epilepsy should be implemented with individual administration.