某院2013-2016年3种抗癫痫药血药水平监测数据分析

Analysis of blood concentration monitoring data of 3 antiepileptic drugs in a hospital from 2013 to 2016

目的 分析盐城地区某医院2013-2016年3种抗癫痫药物的血药水平监测情况,为临床合理用药提供参考。方法 采用回顾性研究方法,对该院2013-2016年3种常用抗癫痫药物(丙戊酸钠、卡马西平、苯妥英钠)血药水平监测数据进行统计、分析。结果 2013-2016年本院AEDs血药水平监测例次总体呈上升趋势,共监测1 020次;其中丙戊酸钠840次,卡马西平135次,苯妥英钠25次;监测结果在有效血药水平范围内的共计553次(54.22%);>18~60岁的中青年患者监测例次最多,占44.22%;接受单药治疗的住院患者共监测438次,其中丙戊酸钠、卡马西平、苯妥英钠血药水平监测结果在治疗窗内的比例分别为53.80%、42.55%、20.00%,差异具有统计学意义(P<0.05)。23例联合用药的住院患者中,抗癫痫药血药水平均在治疗窗内的有6例(26.09%)。结论 血药水平监测对于癫痫患者实施个体化给药具有重要意义。该院AEDs血药水平监测工作仍存在诸多不足,有待进一步改进。

Objective To analyze the blood concentration monitoring of 3 kinds of antiepileptic drugs(AEDs)in a hospital from 2013 to 2016 in order to provide reference for rational use of drugs in clinic.Methods A retrospective investigation and analysis was used to classify monitoring data of the blood concentration of 3 kinds of AEDs in the hospital from 2013 to 2016.Results The number of AEDs blood concentration monitoring cases increased year by year.Among the total 1 020 cases,860 were sodium valproate(VPA),135 were carbamazepine(CBZ)and 25 were phenytoin(PHT).553(54.22%)cases were in the effective plasma concentration range.The main objects of blood concentration monitoring were young and middle-aged(range from 18 to 60),accounting for 44.22%.Among 438 cases receiving single drug therapy,the rates of serum concentrations of VPA,CBZ and PHT in therapeutic window were 53.80%,42.55%and 20.00%,with statistical significance different(P<0.05).Among 23 hospitalized receiving combination therapy,6(26.09%)cases were both in therapeutic window.Conclusion It is of great importance to monitor the blood concentration of anti-epilepsies drugs to provide the individual administration for patients.There are still some problems of AEDs blood concentration in our hospital,and deficiencies needed to be solved and improved.