成人癫痫苯妥英个体化治疗的临床意义

Clinical significance of phenytoin in the individual treatment of adult epilepsy

目的 探讨苯妥英 (PhenytoinPHT)治疗成人癫痫的合理用药。 方法 选择苯妥英钠单药治疗的原发性全身强直一阵挛性发作 (PGTCS)患者 6 7例 ,根据临床效果 ,结合实测血药浓度 ,调整剂量 ,至少观察半年判断临床疗效。结果 不同的个体、不同的病程、不同的病情 ,PHT的有效剂量 (10 0～ 4 5 0mg/d)和血药浓度 (2 .77～ 4 8.5 2 μg/ml)有很大的差异。结论 PHT治疗癫痫应根据个体选择最佳剂量 ,确定有效血药浓度。

Objective To explore reasonable administrations of phenytoin(PHT) in treatment of adult epilepsy.Methods Sixty seven cases of primary generalized tonic clonic seizure with single PHT therapy were investigated. Adjustment of PHT dose depended on clinical effects and drug concentrations in serum and the efficacy was observed for more than half an year.Results There were wide individual variations in effective dose and serum drug concentrations, from 100 mg to 450 mg daily and from 2.77 μg/ml to 48.52 μg/ml respectively. It may be related to courses and degrees of the diseases.Conclusion Optimal doses and serum drug concentrations of PHT should be adjusted according to individul patient.