新疆地区癫痫患者丙戊酸钠血药浓度民族差异性分析

Comparison of Serum Concentration of Valproic Acid among Children of Different Nationalities with Epilepsy in Xinjiang: a Difference-Analysis

目的：探讨新疆地区汉族、维吾尔族、回族、哈萨克族癫痫患者丙戊酸钠（VPA）血药浓度的差异性。方法：选取2011-2013年在我院确诊为癫痫的门诊及住院患者中严格按照说明书剂量长期（〉1周）服用VPA且未联用肝药酶诱导或抑制剂等相关药物的癫痫患者共3 002例,其中汉族1 482例、维吾尔族1 169例、回族154例、哈萨克族197例,采用荧光偏振免疫法测定稳态血药浓度,以50～100μg/m L为治疗窗（有效浓度）,按年龄段0～3岁、4～17岁、18～65岁分别分析其民族差异性。结果：汉族和维吾尔族、回族0～3岁患儿达治疗窗比例分别为60.3%、48.0%、46.0%,达中毒浓度（〉100μg/m L）比例分别为1.2%、7.0%、8.0%,差异均有统计学意义（P均〈0.05）;汉族和维吾尔族4～17岁患儿达治疗窗比例分别为69.0%、48.6%,达中毒浓度比例分别为11.0%、13.0%,差异均有统计学意义（P均〈0.05）;其余同年龄阶段的结果按民族类别两两比较差异均无统计学意义（P均〉0.05）。结论：新疆地区汉族癫痫患儿血药浓度达治疗窗比例高于维吾尔族、回族患儿,达中毒浓度比例低于维吾尔族、回族患儿;而新疆地区汉族、维吾尔族、回族、哈萨克族成人癫痫患者VPA血药浓度比较差异无统计学意义。

Objective： To investigate the differences between the steady-state serum concentrations of valproic acid in the four different nationalities including Han,Uyghur,Hui,Kazak nationalities in Xinjiang. Methods： The steady-state serum concentrations of valproic acid in 3,002 epileptic patients in Xinjiang Uyghur Autonomous Region people＇s hospital were determined by fluorescence polarization immunoassay,and the associations between the steady-state serum concentrations of valproic acid and different nationalities were analyzed. Results： Han,Uyghur and Hui nationalities 0 ～ 3 year-old children to reach the blood concentrations of therapeutic window rates were 60. 3%,48. 0%,46. 0%,reached to the toxic concentration ratios were 1. 2%,7. 0%,8. 0%（ P〈0. 05）. Han,Uyghur nationalities children 4 to 17 years to reach the therapeutic window serum concentration ratios were 69. 0%,48. 6%,reached to the toxic concentration ratios were 11. 0%,13. 0%,there were statistically significant（ P〈0. 05）,and the remaining groups were compared according to different ethnic groups,the difference was not statistically significant（ P〉0. 05）. Conclusion： Xinjiang Han nationality children with epilepsy blood concentration of therapeutic window ratio is higher than Uyghur,Hui nationalities children,poisoning concentration ratio is lower than the Uyghur,Hui nationalities children. The Xinjiang Han,Uyghur,Hui,Kazak nationalities VPA blood concentrations of adults with epilepsy are no statistically significant difference.