我院890例次3种抗癫痫药物血药浓度监测数据分析

Monitoring the plasma concentration of antiepileptic drugs in 890 cases in our hospital

目的分析本院2007-2014年抗癫痫药物(AEDs)血药浓度监测结果,为临床AEDs的合理使用提供参考。方法采用回顾性调查方法,利用SPSS 20.0统计软件对本院890例次AEDs血药浓度监测结果进行统计分析,并观察AEDs的临床疗效和不良反应。结果 2007-2014年本院AEDs血药浓度监测例数大体呈逐年上升趋势,共计监测890例次;其中卡马西平762例次,苯巴比妥66例次,苯妥英钠62例次;472例次(53.03%)血药浓度位于有效血药浓度内,390例次(43.82%)低于有效血药浓度,11例次(1.24%)高于有效血药浓度,17例次(1.91%)未检出血清浓度;卡马西平、苯巴比妥、苯妥英钠血药浓度在有效血药浓度内的临床有效率和不良反应发生率分别为83.65%和9.11%、68.97%和17.24%、92.31%和15.38%;24例次联合用药中,只有6例次(25.0%)在有效血药浓度范围内,有8例次(33.33%)能够有效控制癫痫发作,有4例次(16.7%)出现不良反应。结论血药浓度监测结果是指导临床用药的依据之一,由于AEDs血药浓度个体差异大,需结合其他临床指标综合分析监测结果,实施个体化给药,促进AEDs安全、有效、合理应用。

Objective To monitor and measure the plasma concentration of antiepileptic drugs（AEDs） from 2007 to 2014, and to provide reference for rational use of drug in clinical practice. Methods The data of 890 cases were analyzed retrospectively with SPSS 20.0. We observed the clinical therapeutic effi cacy and adverse drug reaction of AEDs. Results The number of plasma concentration monitoring cases increased year by year. Among the total 890 cases, 762 were carbamazepine, 66 were phenobarbital and 62 were phenytoin. Totally 472 cases（53.03%） were in the effective plasma concentration range, 390（43.82%） were below the effective plasma concentration range, while 11（1.24%） were above the effective plasma concentration range, 17（1.91%） were not detected anything. The clinical therapeutic effi cacy and adverse drug reaction rate of carbamazepine, phenobarbital and phenytoin were 83.65% and 9.11%, 68.97% and 17.24%, 92.31% and 15.38% respectively. In the 24 antiepileptic drug combination cases, 6（25.0%） were in the effective plasma concentration range, 8（33.33%） epileptic seizure cases were effectively controlled, and 4（16.7%） showed adverse drug reactions. Conclusion Plasma concentration monitoring provides an important basis for clinical drug use. Doctors and pharmacists need to consider the individual differences in plasma concentration of AEDs, and carry out individualized administration to promote the safe, effective and rational use of AEDs.