171例次癫痫患者卡马西平血药浓度监测分析

Monitoring of Blood Concentration of Carbamazepine in 171 Cases with Epilepsy

目的分析癫痫患者卡马西平的血药浓度监测结果，为卡马西平的合理用药提供依据。方法采用荧光偏振免疫法测定癫痫患者卡马西平血药浓度，并观察其临床疗效和不良反应。结果171例次患者中，卡马西平血药浓度低于4μg／ml占21．1％，4～12μg／ml的占73．7％，血药浓度〉12μg／ml占5．3％。其中出现中毒反应的占7．0％。171例次患者的癫痫治疗有效率为74．3％。与丙戊酸等联合用药的38例次患者中，总有效率为44．7％。单一用药的总有效率为79．7％，血药浓度越高，疗效越好。卡马西平超出治疗窗，患者的不良反应明显增加。结论卡马西平的血药浓度监测可为临床医生制定个体化给药方案提供客观依据，对提高癫痫治疗的安全性、有效性有重要意义。

Objective To analyze the monitoring result of blood concentration of carbamazepine in patients with epilepsy and provide evidence for rational use of this drug. Methods Fluorescence polarization immunoassay（FPIA） was used to determine the blood concentration of carbamazepine. Therapeutic effects and adverse reactions of carbamazepine were observed. Results The blood concentration of carbamazepine in lower than 4μg/ml , 4-12μg/ml and higher than 12μg/ml accounted for 21.1%, 73. 7% and 5. 3%, respectively. The effective rate of carbamazepine in 171 cases was 74. 3% ,but the rate was only 44. 7% in 38 cases coadministered with carbamazepine and other antiepileptic drugs such as sodium valproate. The effective rate in those patients taking carbamazepine alone was 79. 7%. The higher concentration got better therapeutic effects. Adverse reactions were increased significantly in patients whose blood concentrations of carbamazepine were higher than therapeutic range. Conclusion Monitoring of blood concentration of carbamazepine can provide evidence for making individualized therapeutic regimen and play an important role in the treatment of epilepsy.