丙戊酸钠治疗小儿癫痫的中毒反应及其血药浓度的关系

The significance of analysis of blood drug concentration of valproate for the application of pediatric epilepsy on poisoning reaction

目的探讨小儿癫痫应用丙戊酸钠后出现中毒反应及其血药浓度的关系。方法选取244例癫痫患儿给予丙戊酸钠治疗,应用化学免疫分析法检测患儿血清中药物浓度,记录每例患儿血药浓度、治疗有效率和中毒反应发生率。结果给予丙戊酸钠治疗后,〉100 mg/L组患者中毒反应发生率（16.7%）明显高于50～100 mg/L组（2.4%）和≤50 mg/L组（1.0%）,差异有统计学意义（P〈0.05）;≤6岁组患者中毒反应发生率（9.4%）明显高于6～9岁组（3.8%）和〉9岁组（2.7%）,差异无统计学意义（P〉0.05）。结论中毒反应发生率变化与血药浓度密切相关,监测丙戊酸钠血药浓度对防止中毒反应的发生具有重要意义。

Objective To investigate the significance of analysis of blood dr ug concentration of valproate for the application of pediatric epilepsy on poisoning reaction. Methods 244 children with epilepsy were given sodium valproate treatment to detect the drug concentration in serum, with application of f luorescence polarization immunoassay, recording the treatment effective rate and the toxic reaction rate of each patient. Results After sodium valproate treatment, the poisoning reaction rate（16.7%）of drug concentration of〉 100 mg/L group was higher than that of 50～100 mg/L group（2.4%）and ≤50 mg/L group（1.0%）（P〈0.05）; the poisoning reaction rate（9.4%）of ≤6 years old patients was higher than that of the 6～9 years old g roup（3.8%）and〉 9 years old g roup（2.7%）but with no st atistical sig nif icance（P〉0.05）. Conclusion T he poisoning reaction rate was closely related to the blood concent ration, monitoring the ser um concent ration of sodium valproate has an impor tant signif icance for preventing poisoning reaction.