多种抗癫痫药物联合下丙戊酸血药浓度对疗效的影响分析

Therapeutic Effect Analysis of Valproic Acid with Combination of Multiple Antiepileptic Drugs

目的探讨多种抗癫痫药物联合下丙戊酸血药浓度对疗效的影响。方法采用回顾性研究方法,收集207例确诊癫痫并给予丙戊酸治疗的患儿病例资料,进行统计分析。结果 207例病例中,联合用药有163例(78.7%),左乙拉西坦(58例,28%)和拉莫三嗪(43例,20.8%)联用组占比相对较高。联合用药组的丙戊酸平均血药浓度均在50~100μg·mL-1之间,氯硝西泮组、拉莫三嗪组、奥卡西平联合用药组与单用丙戊酸组相比,平均血药浓度相对较高,且差异具统计学意义(P<0.05)。联合用药组总治疗有效率68.5%,单用丙戊酸治疗有效率为88.6%,差异具有统计学意义(P<0.05)。结论丙戊酸联用其他抗癫痫药物时,血药浓度稍有提高,但是治疗有效率并未随之增加,说明尚有其他因素明显影响丙戊酸的血药浓度。

OBJECTIVE To investigate the therapeutic effect analysis of valproic acid with combination of multiple antiepileptic drugs. METHODS The data of 207 cases of epilepsy diagnosed and treated with valproic acid were collected retrospectively and analyzed. RESULTS Of all 207 cases with epilepsy,163(78.7%) cases were treated with combined antiepileptic drugs,and the valproic acid cases combined with levetiracetam(58 cases,28%) and lamotrigine(43 cases,20.8%) groups were accounted for a relatively high proportion. The average serum concentration of valproic acid combined with antiepileptic drugs was 50~100 μg·mL-1.The average serum concentration of valproic acid combined with clonazepam,lamotrigine and oxcarbazepine groups were higher than the valproic acid group alone,and the results showed significant difference(P<0.05). The total effective rate was 68.5% in valproic acid combined with multiple antiepileptic drugs groups and 88.6% in valproic acid group alone(P<0.05). CONCLUSION When valproic acid was combined with other antiepileptic drugs,the serum concentration of valproic acid increased slightly while the effective rate of treatment did not increase with it,which indicated that there were other factors significantly affected the serum concentration of valproic acid.