癫痫病人脑脊液中苯妥因钠、卡马西平浓度测定及其临床价值

Phenytoin and carbamazepine concentration in CSF:Determination and clinical value inepileptics.

用高效液相色谱法测定９２例癫痫病人脑脊液（ＣＳＦ）中苯妥因钠、卡马西平浓度，并结合临床进行分析，结果发现：ＣＳＦ中苯妥因钠、卡马西平与临床疗效和中枢神经系统的毒副反应关系密切；与血总浓度呈正相关（ｒ＝０．３７，Ｐ＜０．０５；ｒ＝０．７３，Ｐ＜０．０５）；与血游离浓度无显著区别（Ｐ＞０．０５）；药物剂量与ＣＳＦ中苯妥因钠、卡马西平水平无线性关系（ｒ＝０．１３４，Ｐ＞０．０５；ｒ＝０．１４，Ｐ＞０．０５）；病程对血脑屏障通透性的影响可能改变ＣＳＦ中苯妥因钠、卡马西平浓度。

AbstractThe cerebrospinal fluid ( CSF ) concentration of phenytoin(PHT)and carbamazepine(CBZ)were measured in a group of 92 epileptic patients. Levels of both anticonvulsant drugs inrelation to clinical manifestations were analysed,The results showed that CSF-PHT and CSF-CBZlevels correlate with clinical effect and neurotoxicity, An intimate correlation was found betweenCSF and serum concentrations in both PHT and CBZ(r=0.27 P<0.05),The levels of PHTand CBZ in CSF and un bound in serum were of no significant difference. It seems reasonable thatCSF- PHT and CSF-CBZ might correlate with dosage but we were unable to establish such a corre-lation. Repeated seizures may damage the permeability of the Bloed-Brain Barrier(BBB ) in epilip-tic patients.