838例(次)丙戊酸钠血药浓度测定结果分析

目的 通过测定丙戊酸钠血药浓度,为临床合理用药提供药学技术服务.方法 采用荧光偏振免疫法(FPIA)测定838例次患者丙戊酸钠血药浓度,将测定结果进行比较分析.结果 838例次丙戊酸钠测定值在治疗浓度50～100μg/ml范围内421例次(占50.2%),低于治疗浓度范围下限(<50μg/ml)385例次(占45.9%),高于治疗浓度范围上限(>100μg/ml)32例次(占3.8%).结论 丙戊酸钠体内代谢个体差异大,影响其血药浓度及其疗效的因素众多,因此临床使用丙戊酸钠应充分考虑患者的生理、病理和药物相互作用复杂的特点,及时测定血药浓度并根据测定数据综合考虑各方面因素,调整给药方案,以实现较合理的个体化用药.

Analysis of the serum concentration of valproate in 838 cases

Objective Monitoring of valproate serum concentration of drug available for clinical pharmaceutical care. Methods Applying fluorescence polarization immunoassay （ FPIA ） to determinate the serum concentration of valproate, results from 838 cases were compared and analyzed. Results The measured values from 50 to 100μg /ml were 421 case - times, accounting for 50. 2%; a total of 385 case -times were below the lower limit of therapeutic concentration range （ 〈 50μg/ml） , accounting for 45.9% ; a total of 32 case - times were higher than the upper limit of therapeutic concentration range （ 〉 100μg/ ml） , accounting for 3.8%. Conclusion The metabolism of sodium valproate differs largely by individual, there are lots of factors could influence its serum concentration and effects. It should fully consider the clinical use of sodium valproate in patients with physiology, pathology and drug interactions, to adjust dosage regimen timely based on monitoring data, taking various factors, as to achieve a more reasonable individualized medicine.