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联合用药对卡马西平血浓度及临床疗效的影响 被引量:2

INFLUENCE OF MULTIPLEANTIEPILEPTIC DRUGS ON PLASMA LEV-ELS OF CARBAMAZEPINE AND CARBAMAZEPINE- 10, 11-EPOXlDE AND CLIN-ICAL EFFICACY
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摘要 采用高性能液相色层分析法对118例服用卡马西平的癫痫患儿测定了血卡马西平(CBZ)及其中间代谢产物10、11-环氧卡马西平(E-CBZ)药浓度。78例单用CBZ,40例合用其他抗痫药,其中15例合用苯巴比妥(PB)、7例合用苯妥英钠(PHT)、10例合用丙戊酸钠(VPA-Na)、8例合用硝基安定(NTZ)。各组CBZ平均给药剂量相似。结果表明,合用PB或PHT组血CBZ药浓度与临床疗效明显低于单药组(P<0.01)。合用VPA-Na组血CBZ浓度与单药组无显著差异,E-CBZ血浓度明显高于单药组(P<0.01),而临床疗效低于单药组(P<0.05)。合用NTZ组血CBZ及E-CBZ浓度与临床疗效与单药组比较,差异均无显著意义(P>0.05)。提示CBZ抗痫治疗不宜与PB或PHT合用,E-CBZ浓度与临床疗效无相关性。 AbstractPlasma levels of carbamazeoine(CBZ)and carba-niazepine-10.11- epoxide (E-CBZ) in 118 epilepticchildren treated with CBZ alone (78 cases) , and CBZin cornbination with ohenobarbital (PB) (15 cases) ,phenytoin (PHT) (7 cases)>, sodium valproate (VPAnai (10 cases) . nitrazeparn (NTZ) (8 cases) weredeterrnined bv HPLC, and the clinical efficacv wascompared between the diffezant groups.The plasma levels of CBZ and the clinical controlrate in the groups treated with CBZ +PB and CBZ+PHT were significantly lower than those in CBZ alone.The plasma level of E- CBZ in the group treated byCBZ + VPA -na was obviously higher than that ofCBZ alone. There was no significant difference in theplasma level of CBZ between the groups taking CBZalone and CBZ+VPA- na, but the clinical efficacy inthe group of CBZ+VPA-na was poorer than that inCBZ alone. Comparing the group taking CBZ alone andthose taking CBZ+NTZ,4 There was no significant dif-ference both in CBZ and E-CBZ blood levels and clini-cal efficacy betuween the groups taking CBZ alone andCBZ+NTZ;there was no correlaiion between clinicalefficacy and the plasnia level of E-CBZ. Our data sug-gest that in treatrnent of epileiisy, CBZ should not becombined with PB or PHT.
出处 《中华儿科杂志》 CAS CSCD 北大核心 1994年第6期350-352,共3页 Chinese Journal of Pediatrics
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参考文献3

  • 1唐跃年,上海第二医科大学学报,1991年,11卷,240页
  • 2叶祥枝,临床儿科杂志,1990年,9卷,99页
  • 3陈刚,治疗药物监测,1988年

同被引文献7

  • 1陈 刚.治疗药物监测[M]人民军医出版社,1988.
  • 2Miesnikowjcz FJ,Sherwin AI. Elevation of plasma carbamaz-epine epoxide levels by comedication with valproate or primi-done[J].{H}EPILEPSIA,1985.538-551.
  • 3Brodie MJ,Forrest G,Rapeport WG. Carbamazepine 10,11-expoxide concentration in epilepsia on carbamazepine alone and in combination with other anticonvulsants[J].J Clin Pharma-col,1983.747-754.
  • 4Perucca E. Clinically relevant drug interactions with antiepilep-tic drugs[J].{H}British Journal of Clinical Pharmacology(England),2006,(03):246-255.
  • 5Pisani F,Caputo M,Fazio A. Interaction of carbamaz-epine-10,11-epoxide,an active metabolite of carbamazepine,with valproate:a pharmacokinetic study[J].{H}EPILEPSIA,1990,(03):339-342.
  • 6Bourgeois BFD. Anticonvulsant potency and neurotoxicity of valproate alone and in combination with carbamazepine or phe-nobarbital[J].Clin Neurophamacol,1988,(04):348-359.
  • 7刘学伍,孙建英,迟兆富.抗癫癎药物的相互作用及其机制研究[J].中华神经科杂志,2003,36(3):219-221. 被引量:6

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