102例癫痫患者卡马西平唾液浓度与血药浓度测定及其相关性研究

Determination of serum and salivary carbamazepine concentrations by RP-HPLC and the correlation of that in saliva and in serum in 102 patients with epilepsy

目的:探讨癫痫患者卡马西平唾液浓度与血药浓度的相关性。方法:选择我院2007年9月至2009年3月住院患者102例,服药达稳态血药浓度后,采集肘静脉血2mL,并同时收集自然状态下分泌的唾液1mL,用反相高效液相色谱法同时测定唾液浓度与血药浓度。数据分析采用SPSS11.5统计学软件。结果:以卡马西平浓度(C)、峰面积(A)作线性回归,分别得到血清浓度与唾液浓度的回归方程:C=1.34×10-5A-0.25(r=0.9958)和C=4.07×10-6A-0.30(r=0.9921);唾液浓度(y)与血药浓度(x)回归方程为y=2.54×10-1x-1.09×10-2(n=102,r=0.8985,P<0.01)其比值为24.89%±3.90%。结论:HPLC法测得卡马西平唾液浓度与血药浓度具有显著的相关性,CBZ唾液/血清药物浓度比不受性别、年龄影响,其间无相关性;可以用唾液代替血清对卡马西平作治疗药物监测。

Objective： To study the correlation of carbamazepine concentrations in saliva and in serum in patients with epilepsy. Methods： We selected 102 examples of the hospitalized patients in the Huai＇an NO. 3 People＇s Hospital from Sep. 2007 to Mar. 2009. When approcching the steady drug concentration, 2.0 mL elbow venous blood and 1.0 mL saliva samples were collected and determined by RP-HPLC. Statics software SPSS 11.5 was used for data analysis. Results： Linear regression analysis were made by carbamazepine concentrations （C） and their peak area（A）. The C-A regression equations of serum concentration and saliva concentrations were C = 1.34 × 10^ -5A -0.25 （r = 0. 995 8）and C = 4.07 × 10 ^-6A - 0.30 （ r = 0. 992 1 ） , respectively. The correlation between carbamazepine serum concentration （x） and saliva concentration （y） was y = 2.54 × 10^ - 1 x - 1.09 × 10^-2 （ n = 102, r = 0. 898 5, P 〈0.01 ）. The mean carbamazepine concentration ratio of saliva to serum was 24.89% ± 3.90%. Conclusions： A significant positive correlation was found between earbamazepine serum and saliva concentrations. The ratio of CBZ concentration in saliva to that in serum was not affiliated with sex and age, and there was no correlation between them. Saliva sample may be a useful alternative to serum for therapeutic drug monitoring of carbamazepine treatment.