顿服卡马西平维持夜间有效血药浓度成人适宜剂量的探讨

A Study of Once-daily Adult Optimal Dosage of Carbamazepine for Maintaining Therapeutic Serum Concentration During Night

目的 探讨顿服卡马西平维持夜间有效血药浓度成人适宜剂量 ,为治疗夜间发作性癫痫提供参考意见。方法 以目前较普遍接受的卡马西平 (CBZ)治疗癫痫的有效血药浓度 4～ 1 0mg/L为标准 ,将两组门诊成人癫痫病人共 3 2例在下午 7时晚餐后顿服不同剂量卡马西平 ,一组服CBZ 3 0 0mg,另一组服CBZ 2 0 0mg ,连续服用 1 0天 ,分不同时段采集血液标本 ,采用高效液相色谱仪 (HPLC)监测其血清卡马西平浓度 ,与有效血药浓度比较并进行t检验。结果 维持夜间最低有效血药浓度的剂量不宜低于 3 0 0mg ,其维持时间约 7h ,2 0 0mg不能达到和维持最低有效血药浓度。结论 使用睡前顿服CBZ3 0 0mg治疗夜间发作性癫痫从血药浓度上考虑是可行的。

Objective:To find out once-daily adult optimal dosage of CBZ for maintaining effective serum concentration during night, and to give reference for the treatment of nocturnal seizure. Methods: This project is based on a generally received standard at present that the serum concentration of 4～10 mg/L of CBZ is effective on the treatment of epilepsy. After having supper and taking CBZ of different dosage(one group taking CBZ 300 mg,the other group taking CBZ 200 mg) at 7 pm for 10 days, two groups totalled 32 adult epileptic outpatients were undergone blood-drawing according to different time interval for monitoring their serum concentration using high-performance liquid chromatography(HPLC) ,then carry on the students t test compared with the effective serum concentration. Results:The dosage cannot be less than 300 mg for maintaining effective serum concentration during night. This concentration can be maintained for seven hours, but it can't be maintained when the CBZ dosage is 200 mg. Conclusions:It is available to use this method of once-daily treatment nocturnal seizure in CBZ 300 mg considering serum concentration.