左乙拉西坦治疗儿童癫痫的药效学研究

Pharmacodynamic Analysis of Levetiracetam in the Treatment of Epilepsy in Children

目的:探讨左乙拉西坦用于儿童癫痫的药效、血药浓度与剂量的关系,为左乙拉西坦的儿童用药提供一定的参考。方法:采用NONMEN软件和Oracle crystal ball软件,对左乙拉西坦血药浓度和癫痫发作频率进行分析。结果:NONMEM软件分析结果显示,随着左乙拉西坦血药浓度的增加,疗效趋于变好;癫痫控制概率为50%时,对应的血药浓度为24μg/mL;当血药浓度达到36μg/mL时,癫痫控制概率升高不明显。Oracle crystal ball软件分析结果显示,左乙拉西坦治疗儿童癫痫的最佳用药剂量为20~48 mg/(kg·d)。结论:左乙拉西坦的血药浓度与疗效具有一定的相关性,但不是药物浓度越高,疗效越好,治疗儿童癫痫需要个体化用药。

OBJECTIVE:To probe into the correlation between efficacy,blood concentration and dose of levetiracetam in the treatment of children with epilepsy,so as to provide a certain reference for the medication of levetiracetam in children.METHODS:Levetiracetam blood concentration and epilepsy frequency were analyzed by NONMEN software and oracle crystal ball software.RESULTS:NONMEM software analysis showed that the efficacy tended to become better as the levetiracetam blood concentration increased.When the epilepsy control rate was 50%,the corresponding blood concentration was 24μg/mL.When the blood concentration reached 36μg/mL,the increase of epilepsy control rate was not significant.Analysis results of oracle crystal ball software showed that the optimal dosage of levetiracetam in the treatment of children with epilepsy was from 20 mg/(kg·d)to 48 mg/(kg·d).CONCLUSIONS:The blood concentration of levetiracetam has a certain correlation with the efficacy,but it is not that the higher the drug concentration,the better the efficacy.The treatment of epilepsy in children requires individualized medication.