1 018 例癫痫患儿丙戊酸钠血药浓度监测及影响因素分析

目的:分析癫痫患儿丙戊酸钠(VPA)血药浓度的监测结果,为临床用药提供依据。方法:采用高效液相色谱法测定1 018例癫痫患儿的VPA血药浓度,分析年龄、性别、给药剂量和药物剂型等因素对VPA血药浓度的影响以及VPA血药浓度与疗效之间的关系。结果:癫痫患儿VPA血药浓度低于治疗窗的528例(51.9%),位于治疗窗内的464例(45.6%),高于治疗窗的26例(2.6%)。年龄、性别和给药剂量对VPA血药浓度的影响差异有统计学意义(P < 0郾05),药物剂型对VPA 血药浓度的影响差异无统计学意义(P>0.05),VPA血药浓度与疗效之间存在统计学差异(P<0.05)。结论:VPA血药浓度个体差异大,且受癫痫患儿年龄、性别和给药剂量等因素影响,为实现个体化药物治疗,应常规监测血药浓度。

Serum Concentration Monitoring of Sodium Valproate and Its Influential Factors in 1,018 Cases Pediatric Epilepsy

Objective: To provide references for clinical drug administration by analyzing the serum concentrations of sodium valproate (VPA) in pediatric epilepsy. Methods: High performance liquid chromatography was used to detect the serum concentrations of sodium valproate in 1,018 cases pediatric epilepsy. The impact of age, gender, dose and dosage forms on the serum concentrations of VPA and the relation between the serum concentrations of VPA and therapeutic effect were analyzed. Results: Among the serum concentrations of VPA in 1,018 cases, 528 cases (51.9%) were lower than therapeutic window concentration, 464 cases (45.6%) were in the therapeutic window concentration, 26 cases (2.6%) were higher than therapeutic window concentratio. The impact of age, gender and dose on the serum concentrations of VPA had statistical differences (P<0.05), while the dosage form had no statistical difference (P>0.05). There was statistical difference between the serum concentrations of VPA and therapeutic effect (P<0.05). Conclusion: Serum concentration of VPA in pediatric epilepsy children is related to age, gender, drug dose and other factors. There are great individual differences in serum concentration of sodium valproate among children. The monitoring of sodium valproate will be great important reference to drug administration for pediatric epilepsy.