1551例癫痫患者使用卡马西平、丙戊酸钠血药浓度监测结果回顾性分析

Retrospective Analysis of Monitoring Results of Blood Concentration in 1 551 Patients with Anti-Epileptic Drugs

目的:探讨莆田学院附属医院(以下简称“我院”)抗癫痫药血药浓度监测情况,促进临床合理用药。方法:采用回顾性方法,对2015—2017年我院1551例患者(单独使用丙戊酸钠1107例,单独使用卡马西平403例,二者联合应用41例)抗癫痫药血药浓度监测结果进行统计分析,观察血药浓度对治疗效果的影响。结果:1107例单独使用丙戊酸钠的患者中,丙戊酸钠血药浓度为有效血药浓度(50~100μg/ml)的患者有722例(占65.22%),其治疗总有效率明显高于丙戊酸钠血药浓度<50μg/ml的患者,差异有统计学意义(P<0.05);403例单独使用卡马西平的患者中,卡马西平血药浓度为有效血药浓度(4~12μg/ml)的患者有292例(占72.46%),其治疗总有效率明显高于卡马西平血药浓度<4μg/ml的患者,差异有统计学意义(P<0.05)。结论:临床应用丙戊酸钠、卡马西平治疗癫痫患者时,为减少不良反应的发生,有必要进行血药浓度监测,以及时调整给药剂量。

OBJECTIVE: To investigate the monitoring results of blood concentration in patients with anti-epileptic drugs in the Affiliated Hospital of Putian University(hereinafter referred to as "our hospital"), so as to promote the rational drug application in clinic. METHODS: Retrospective method was used to analyze the blood concentration in 1 551 patients with anti-epileptic drugs(1 107 cases were treated with sodium valproate alone,403 cases were treated with carbamazepine alone and 41 cases of combined use of the above two drugs) in our hospital from 2015 to 2017. The effects of blood concentration on the therapeutic effects were observed. RESULTS: Of the 1 107 patients treated with sodium valproate alone, 722 patients(65.22%) had a blood concentration of valproate as the effective blood concentration(50-100 μg/ml), the total effective rate was significantly higher than that of the patients with blood concentrations of sodium valproate <50 μg/ml, with statistically significant difference(P<0.05). Of the 403 patients received carbamazepine alone, 292 patients(72.46%) had a blood concentration of carbamazepine as the effective blood concentration(4-12 μg/ml), the total effective rate was significantly higher than that of the patients with blood concentrations of carbamazepine <4 μg/ml, with statistically significant difference(P<0.05). CONCLUSIONS: In order to reduce the occurrence of adverse drug reactions in the clinical application of valproate sodium and carbamazepine in the treatment of epileptic patients, it is necessary to monitor the blood drug concentration and adjust the dosage.