丙戊酸钠血药浓度监测对癫痫患儿治疗的临床意义

Clinical significance of therapeutic drug monitoring of sodium valpoate in epileptic children

目的监测癫痫患儿丙戊酸钠血药浓度,分析其对癫痫患儿治疗的影响.方法采用回顾性调查分析,利用HIS抽取某院2018年1月1日~2018年6月30日门诊内科510例癫痫患儿的病历,采用Excel进行统计分析.结果丙戊酸钠血药浓度处于50~100μg/ml的癫痫患儿有308例;丙戊酸钠血药浓度<50μg/ml的癫痫患儿有178例;丙戊酸钠血药浓度>100μg/ml的癫痫患儿有24例;当丙戊酸钠血药浓度>120μg/ml时癫痫患儿的不良反应发生率最高.结论癫痫患儿个体差异性大,服药依从性差,而丙戊酸钠有效治疗窗窄,所以对于应用丙戊酸钠的癫痫患儿应密切监测其血药浓度,提高治疗效果.

Objective To investigate the effect of sodium valproate plasma concentration on children with epilepsy. Methods Retrospective investigation and analysis were conducted. The medical records of 510 children with epilepsy in outpatient department from January 1 to June 30, 2018 were collected by HIS. Statistical analysis was performed by Excel. Results There were 308 epileptic children treated with sodium valproate in the serum concentration of 50 ~ 100 μg/ml, and 178 with sodium valproate blood concentration < 50 μg/ml. There were 24 children with plasma concentration > 100μg/ml, and the incidence of adverse reactions was highest in epileptic children with sodium valproate plasma concentration > 120μg/ml. Conclusion Children with epilepsy have large differences in individuality and poor medication compliance, while sodium valproate has a narrow therapeutic window. Therefore, the epileptic children should closely monitor their blood concentration when they used the drug of sodium valproate, which could help to improve the therapeutic effect.