375例抗癫痫药物血药浓度监测结果分析

Analysis of serum antiepileptic drugs concentration in 375 cases

目的通过对抗癫痫药物血药浓度的监测,为调整药物剂量、评价药物不良反应和保证治疗效果提供依据。方法采用荧光偏振免疫法及高效液相色谱法对未合并用药的138例服用丙戊酸、151例服用卡马西平、21例服用苯妥英、65例服用苯巴比妥的癫痫患者进行血药浓度监测。结果丙戊酸、卡马西平、苯妥英和苯巴比妥有效血药浓度范围分别为50—100、4—12、10-20和15-40 μg／mL,有效血药浓度范围内的控制率明显高于浓度范围外的控制率。苯妥英和苯巴比妥均有中毒病例发生。结论血药浓度监测对抗癫痫药物的个体化给药十分必要,应紧密结合临床症状,做到安全、有效用药。

Objective To provide information for adjusting administration dosage, evaluating drug adverse reactions and ensuring the therapeutic effects of oral antiepileptic drugs in clinic by detecting serum drug concentrations of antiepileptic drugs. Methods Serum drug concentrations of valproic acid, carbamazepine, phenytoin and phenobarbital were determined in 138, 151, 21 and 65 epileptic patients by fluorescence polarization immunoassay and HPLC, respectively. Results The effective concentrations of valproic acid, carbamazepine, phenytoin and phenobarbital were 50-100, 4-12, 10-20 and 15-40 μg/mL, respectively. The controlling rate within effective concentration was higher than that out of the effective concentration. Poisoned cases were found in phenytoin and phenobarbital groups. Conclusion The administration of oral antiepileptic drugs to epileptic patients must be based on the data of drug concentration in serum and clinic signs must also be considered for safety and effectiveness.