癫癎患儿血清卡马西平血药质量浓度的影响因素

Affecting Factors of Serum Carbamazepine Concentrations in Children with Epilepsy

目的研究癫痫患儿血清卡马西平（CBZ）血药质量浓度的影响因素。方法对采用CBZ治疗的癫痫患儿74例血样进行检测。年龄9个月～18岁，采用高效液相色谱分析法测定其稳态血清质量浓度。采用多元逐步回归分析法进行分析。结果仅用药剂量、年龄对CBZ血药质量浓度的影响有显著意义（P〈0．05）。如用CCBZ代表CBZ血药质量浓度（mg／L），D代表用药剂量（mg／kg），用M代表年龄（个月），则多元回归方程为CCBZ=2．791＋0．017M＋0．078D（r=0．434 P=0．001）。结论CBZ血药质量浓度受多种因素影响，以用药剂量和年龄影响最明显；在无血药质量浓度监测条件的医疗单位，可大致利用目标水平和年龄来计算其用药剂量。

Objective To analyze affecting factors in serum carbamazepine（CBZ） concentrations. Methods Serum CBZ concentrations were measured in 74 chidren with epilepsy,aged from 9 months to 18 years. Homeostasis concentrations were measured by high proficiency liquid chromospectry（HPLC） in all of the cases. Data were analyzed by multinomial linear stepwise regression of SPSS 11.5 version. Results It showed that only dosage and age had marked influence on serum CBZ concentration （ P 〈 0.05 ）. If we assigned CCBZas serum CBZ concentration（mg/L） ,D as dosage（mg/kg） and M as age, its multimonial formula was CCBZ= 2. 791 ＋ 0. 017M ＋ 0. 078D （ r = 0. 434 P = 0. 001 ）. Conclusions Although serum CBZ concentrations influence by many factors. Among 24 possible factors, only CBZ dosage and age of children significantly affect serum CBZ concentration（ P 〈 0.05 ）. Thus, clinicians can calculate CBZ dosage by target concentration and children＇s age if therapeutic drug monitoring can＇t be performed in the grassrcot hospitals.