2013～2014年358例丙戊酸血药浓度监测结果分析

Serum valproate concentration in 358 patients from 2013 to 2014

目的探讨丙戊酸血药浓度监测及临床意义。方法采用酶放大免疫法测定358例患者血清中丙戊酸浓度,并对其结果进行回顾性分析与总结。结果 232例监测结果在有效治疗范围内(50~100mg·L^(-1)),占64.80%;低于治疗范围浓度下限(<50 mg·L^(-1))的有66例,占18.44%;高于治疗范围浓度上限(>100 mg·L^(-1))的60例,占16.76%。患者的年龄、丙戊酸盐的剂型、丙戊酸盐与卡马西平联用均会影响丙戊酸盐的血药浓度。结论丙戊酸血药浓度监测结果显示个体差异大,临床上应用丙戊酸治疗双相情感障碍与癫痫时,应监测血药浓度并实行个体化给药,以提高临床疗效,减少药物不良反应的发生。

Objective To explore the monitor of plasma concentration of valproate and its clinical signifi- cance. Methods The serum valproic acid concentration in 358 epileptic patients and bipolar disorder patients was measured by fluorescence polarization immunoassay. The relationship between the plasma concentration and the clinical efficacy was reviewed. Results The measured results of 232 （64.80%） patients were within the effective concentration range （50 - 100 mg · L-1）, those of 66 （18.44%） patients were under while 60 （16,76%） patients exceeded that range. The patient age, valproate formulation and carbamazepine, would all affect the serum concentration of valproate. Conclusion The plasma concentration of valproate varies greatlyamong individuals, so it should be regularly monitored and the dose should be adjusted in time during medi- cation to improve the clinical efficacy and reduce adverse drug reactions.