丙戊酸钠血药浓度对癫痫病患者临床疗效及血清中HMGB1、IL-2、IL-6水平的影响

Effect of Sodium Valproate Blood Concentration on the Clinical Efficacy and Serum Levels of HMGB1,IL-2 and IL-6 in Patients with Epilepsy

为了研究丙戊酸钠的血药浓度对癫痫患者治疗的效果及血清中HMGB1、IL-2、IL-6水平的影响,观察2013年1月至2018年5月就诊于本院门诊并确诊为癫痫的患者病例150人,均采用丙戊酸钠口服治疗,对患者的丙戊酸钠血药浓度进行监测,根据血药浓度结果分为高浓度组(> 100μg/m L)、中浓度组(50～100μg/m L)和低浓度组(<50μg/m L)。回顾对比3组脑电图结果好转时间及异常放电例数比例、治疗后发作频次、SES评价分数、总有效率,血清中HMGB1、IL-2、IL-6水平及不良反应情况。高浓度组、中浓度组脑电图好转时间及异常放电比例显著低于低浓度组(P <0. 05);高浓度组、中浓度组的3个月及6个月发作频次显著低于低浓度组(P <0. 05);高浓度组、中浓度组的SES自尊评价平均得分显著高于低浓度组(P <0. 05);高浓度组、中浓度组总有效率显著高于低浓度组(P <0. 05)。治疗后血清中HMGB1、IL-2、IL-6浓度,高浓度组、中浓度组的HMGB1、IL-2、IL-6浓度显著低于低浓度组(P <0. 05),高浓度组、中浓度组HMGB1、IL-2、IL-6浓度无明显差异(P> 0. 05)。在安全性方面,高浓度组不良反应发生率显著高于其他两组(P <0. 05)。丙戊酸钠的血药浓度在50～100μg/m L范围内对癫痫治疗有着良好而稳定的疗效和较少的不良反应。血药浓度监测能够为丙戊酸钠的合理用药提供依据。

To study the effect of sodium valproate on the treatment of epilepsy and the levels of HMGB1,IL-2 and IL-6 in serum,150 cases of epilepsy from January 2013 to May 2008 were treated with sodium valproate orally. The serum concentration of sodium valproate was monitored. The patients were divided into high concentration group( > 100 μg/m L),medium concentration group( >50 ~100 μg/m L),and low concentration group( <50 μg/m L). The improvement time of EEG results and the proportion of abnormal discharge cases,the frequency of seizures after treatment,SES score,total effective rate,serum levels of HMGB1,IL-2,IL-6 and adverse reactions were retrospectively compared among the three groups. In terms of efficacy,the improvement time and abnormal discharge rate of EEG in high concentration group and middle concentration group were significantly lower than those in low concentration group [the total effective rate of high concentration group and middle concentration group was significantly higher than that of low concentration group( P < 0. 05) ]. After treatment concentrations of HMGB1,IL-2 and IL-6 in serum of high concentration group and middle concentration group were significantly lower than those of low concentration group( P < 0. 05),concentrations of HMGB1,IL-2 and IL-6 in high concentration group and middle concentration group had no significant difference( P > 0. 05). In terms of safety,the incidence of adverse reactions in the high concentration group was significantly higher than that in the other two groups( P < 0. 05). The serum concentration of sodium valproate in epilepsy patients ranged from 50 ~ 100 μg/m L had a good and stable effect and fewer adverse reactions. Blood concentration monitoring can provide a basis for rational use of valproate.