76例癫痫患者苯妥英血药浓度监测

Monitoring of phenytoin serum concentration in 76 epileptic patients

目的:分析苯妥英治疗癫痫血药浓度与剂量、疗效的关系。方法:以荧光偏振免疫法(FPIA)对171例次癫痫患者进行苯妥英血药浓度监测。结果:有效控制癫痫发作的浓度为(12.9±6.5)μg·ml-1,其中10～20μg·ml-1范围内的占54.72%。剂量0.3g·d-1时,平均血药浓度为(13.6±7.0)μg·ml-1,约60%的病例癫痫得到有效控制,2.4%发生中毒。

OBJECTIVE:To study the relations of phenytoin serum concentration to dosage and effect of treatment of epilepsy seizures.METHODS:The serum concentration of phenytoin of 171 cases was monitored by using the method of fluorescence polarization immunoassay (FPIA).RESULTS:The effective serum concentration of phenytoin was ( 12.9 ± 6.5 )μg·ml -1 ,the range of therapeutic clinical concentration (10～20 μg·ml -1 ) was found in 54.72% of the patients with well controlled seizures.The average phenytoin concentration was ( 13.6 ± 7.0 )μg·ml -1 in the patients with dose 0.3 g·d -1 ,fully seizer control was achieved in 60%,and marked phenytoin toxicity was seen in 2.4% of these cases.CONCLUSIONS:Phenytoin serum concentration monitoring can be used to guide rational use of antiepileptic drugs.