癫痫患者单用奥卡西平时其活性代谢产物血药浓度的影响因素分析

Impact Factor Analysis of Blood Concentrations of Active Metabolite in Epileptic Patients Treated with Oxcarbazepine Alone

目的:考察癫痫患者奥卡西平活性代谢物10,11-二氢-10-羟基卡马西平(简称10-羟基卡马西平)血药浓度的影响因素,包括身高、体重、身体质量指数(BMI)、年龄、性别、体表面积(BSA)、不同基因型(UGT1A9 rs2741049、UGT2B15 rs1902023、HNF4αrs2071197)等。方法:选取2021年10月~2022年8月于本院就诊的单服奥卡西平的汉族癫痫患者共66例,采用高效液相色谱法(HPLC)测定10-羟基卡马西平的稳态血药谷浓度,采用Sanger法直接测序进行基因分型,应用相关性分析等方法分析不同因素对10-羟基卡马西平血药浓度的影响。结果:性别、体重与10-羟基卡马西平的血药浓度无显著相关性;年龄、体表面积、身高与10-羟基卡马西平血药浓度呈正相关;UGT2B15(rs1902023)的CC型与CA基因型间存在一定的差异(P=0.0348,t=2.185)。结论:年龄、体表面积、身高及UGT2B15(rs1902023)的基因型与10-羟基卡马西平的血药浓度有关。

Objective:To observe the factors affecting the blood concentrations of 10,11-dihydro-10-hydroxycarbamazepine(10-hydroxycarbamazepine)in epilepsy patients,including height,weight,body mass index(BMI),age,gender,body surface area(BSA),different genotypes(UGT1A9 rs2741049,UGT2B15 rs1902023,HNF4αrs2071197),etc.Methods:A total of 66 epileptic patients of Han ethnic group who were treated in our hospital from October 2021 to August 2022 and took oxcarbazepine as a single drug were selected.HPLC was used to determine the steady-state blood drug trough concentrations of the active metabolite of 10-hydroxycarbamazepine.Genotyping was performed by direct sequencing with the Sanger method,and the effects of different factors on the blood concentrations of 10-hydroxycarbamazepine were analyzed by correlation analysis.Results:There was no significant correlation between gender or weight and 10-hydroxycarbamazepine concentrations.Age,BSA and height were positively associated with 10-hydroxycarbamazepine,and there were differences between CC and CA genotypes of UGT2B15(rs1902023)(P=0.0348,t=2.185).Conclusion:Age,BSA,height and the genotype of UGT2B15(rs1902023)were related with blood concentrations of 10-hydroxycarbamazepine.