儿童医院4种治疗药物监测数据结果及分析

Data analysis of monitoring for 4 therapeutic drugs in children's hospital

目的：对我院2012年治疗药物监测（TDM）的4种药物的基本情况、患者性别与年龄分布、血药浓度测定结果分布以及与临床疗效的相关性进行分析，评价血药浓度-9临床用药的规律，指导临床合理化给药。方法：对我院2012年度丙戊酸钠、卡马西平、地高辛和环孢素TDM测定结果进行分析，重点对样品量较大的丙戊酸钠和环孢素进行分析讨论。结果：2714例接受丙戊酸钠血药浓度监测的患者中，门诊病例数远远超过住院病例数，男性患者多于女性患者，患者年龄从0～20岁平均分布，63．89％的患者血药浓度在有效范围之内；325例接受环孢素血药浓度监测的患者中，门诊病例数与住院病例数相当，男性患者多于女性患者，患者年龄从1～20岁平均分布，1岁以下患者很少，71．08％的患者血药浓度在有效范围之内。结论：利用回顾性调查的方法对治疗药物监测的数据进行分析，不但可以为临床合理化用药提供依据，同时结合分析结果与不同人群的特点探索适合的测定条件，提高监测的准确度，拓展治疗药物监测的应用范围，使其能更好的服务于临床。

Objective： To evaluate the regulations between drug usage and concentration, and provide suggestion for rational drug use by analyzing the basic information, age-sex distribution, results of therapeutic drug monitoring （TDM） and the correlation between results and clinical effect in our hospital in 2012. Methods： The monitor results of sodium valproate, earbamazepine, digoxin and eyelosporine were analyzed. The results of sodium valproate and cyclosporine were especially discussed. Results： A total of 2 714 patients in ages ranging from 0 to 20 years receiving sodium valproate TDM in 2012 were collected. The number of outpatients exceeded inpatients, males were over females, and the average effective concentration was 63.89%. A total of 325 patients in ages ranging from 1 to 20 years receiving cyclosporine TDM in 2012 were collected, the number of outpatients was equal to inpatients, males were over females, and the average effective concentration was 71.08 %. Conclusion ： According to the TDM data analysis, we provide suggestions for clinic rational drug use and suitable determination conditions, in order to increase the accuracy of determination and expand the field of TDM application.