液质联用法监测癫痫患儿卡马西平血药浓度及结果分析

The Clinical Applicaition of LC-MS on Plasma Concentration Determination of Epileptic Patients

目的：建立液谱质谱联用法（LC—MS），对卡马西平（CBZ）进行血药浓度监测，同时探究卡马西平血药浓度与癫痫疗效的关系。方法：以本院小儿神经内科的168例癫痫患者作为研究对象，采用高效液相色谱质谱（1iquidchromatography—massspectrometry，LC—MS）方法对其血药浓度进行监测。结果：卡马西平血药浓度在2．0～40．0mg／L的范同内线性关系良好（r=0．9967）。168例癫痫患者中有104例的CBZ血药浓度为4～12mg／L，其中81例显效或有效，23例效果不明显，有效率为77．9％。48例患者的CBZ血药浓度〈4mg／L，占全部患者的28．6％，其中15例患者有效，其余无效；16例患者的CBZ血药浓度〉12mg／L，全部有效。结论：本文中LC—MS方法专属性强，灵敏度、准确度以及重现性均较好，易于操作，可用于癫痫患者血清中卡马西平血药浓度的监测。卡马西平治疗癫痫的疗效以及不良反应和CBZ血药浓度密切相关。

Objective： To develop the method of LC-MS for the concentration of Cabamazepine （ CBZ ） in human blood, and to discuss the relationship between CBZ blood concentration and antiepileptie effects. Method： 168 cases epileptic patients in our hospital were retrospectively analyzed.And liquid chromatography-mass spectrometry （ LC-MS ） has been developed to monitor the CBZ blood concentration. Result： The liner calibration curve of Cabamazepine was obtained in the concentration range of 2.0-40.0 mg/L （ r=0.9967 ） . 104 cases CBZ blood concentration was in 4-12 mg/L, 81 cases in their were shown effective and 23 cases were ineffective, the effective ratio was 77.9%. 48 cases CBZ blood concentration was lower than 4 mg/L. 16 cases CBZ blood concentration was higher than 12 mg/L and all these patients were effective. Conclusion： LC-MS method in this article is proper, sensitivity, accuracy and repeatability. Meanwhile it is easy to operate for monitoring the CBZ blood concentration of epileptic patients. The effectively of CBZ and adverse effects are closely related to CBZ blood concentration.