164例/次丙戊酸钠血药浓度监测影响因素和安全用药分析

Influencing factors and safety analysis of 164 cases of sodium valproate blood concentration monitoring

目的分析164例/次丙戊酸钠(Sodium Valpeoate,VPA)血药浓度监测结果,探讨影响VPA血药浓度的因素及不良反应发生情况。方法回顾性分析本院经高效液相色谱法对本院门诊及住院癫痫患者的VPA血药浓度检测结果,分析影响结果的因素及不良反应发生情况。结果 164例/次VPA血药浓度监测中在有效浓度范围的共109例(66.46%),在该浓度范围内临床治疗有效率显著高于治疗窗外患者;61~87岁患者VPA血药浓度有效率低于21~40岁患者(x^2=5.02,P<0.05),同时低于41~60岁患者血药浓度有效率(x^2=8.09,P<0.05),差异均具有统计学意义。VPA不良反应发生率约为20.18%。结论丙戊酸钠血药浓度有较高的个体差异,且不良反应较为常见,应监测血药浓度以便安全用药。

Objective To analyze the monitoring results of serum concentration of 164 cases of sodium hypovalproate(VPA), and to explore the factors influencing the concentration of VPA and the occurrence of adverse reactions. Methods Retrospective analysis of our hospital outpatient and inpatient epilepsy by high performance liquid chromatography VPA blood concentration test results, analysis of the factors affecting the results and adverse reactions. Results A total of 109 of 164 cases(66.46%) of VPA serum concentration monitoring were within the effective concentration range, and the effective rate of clinical treatment was significantly higher than that of patients outside the treatment window. The effective rate of VPA serum concentration in 61-87 year old group was lower than that in 21-40 year old group(x^2=5.02, P<0.05), and lower than that in 41-60 year old group. The difference was statistically significant(x^2=8.09, P<0.05). The incidence of adverse reactions in VPA was about 20.18%. Conclusion The serum concentration of sodium valproate has a high individual difference, and adverse reactions are common. It is necessary to monitor the serum concentration of sodium valproate for safer use of drugs.