我院癫痫儿童左乙拉西坦血药谷质量浓度影响因素的回顾性分析

A retrospective analysis on factors that influence serum concentration of levetiracetam on children with epilepsy in our hospital

目的探讨癫痫儿童口服左乙拉西坦(LEV)后血药谷质量浓度与年龄、性别、剂量体重比(日服药剂量/体重)、抗癫痫药物(AEDs)联合用药和临床疗效的相关性。方法回顾性分析我院129例次LEV治疗癫痫患儿的药物监测资料,将血药谷质量浓度值、年龄、性别、剂量体重比、联合用药和临床疗效等资料录入数据库,运用SPSS 13.0软件及多元回归模型进行分析处理。结果患儿LEV血药谷质量浓度与剂量体重比呈正相关,合并服用硝西泮和卡马西平相对于单用LEV时会升高LEV血药谷质量浓度;当LEV血药谷质量浓度>11μg·mL^(-1)时增加服药剂量,疗效增加没有显著差异。结论左乙拉西坦在儿童体内的代谢过程存在一定的个体差异性,可能与剂量体重比和联合用药相关,因此血药质量浓度监测对制订个体化给药方案有重要意义。

AIM To investigate the correlations between serum concentration of levetiracetam （LEV） with age, gender, dose per body weigh （medication dose/body mass） , anti- epileptic drugs （AEDs） combination and clinical therapeutic effects in epileptic children. METHODS The therapeutic drug monitoring data of 129 epilepsy children with oral LEV treatment was retrospectively analyzed. Database was built with serum concentration values, age, gender, dose per body weigh, drug combination and clinical therapeutic effects, SPSS 13.0 software and multiple regression model was used for analysis and processing. RESULTS LEV serum concentrations were positively correlated with dose per body weigh, the LEV serum concentration was raised after combining with nitrazepam （NZP） and carbamazepine （CBZ）. The maximum effective serum concentration of LEV was 11μg.mL^-1. CONCLUSION The inter-individual variation in the metabolic processes of levetiracetam within individual patient was remarkable, which maybe related with dose per body weight and AEDs in combination. Therefore, the serum drug concentration monitoring is important for individualized dosage regimen development.