顿服卡马西平治疗夜间发作性癫痫的实验研究

A Experiment Investigation of Once-daily Adult Optimal Dosage of Carbamazepine for Treatment of Nocturnal Seizure

目的 探讨顿服卡马西平治疗夜间发作性癫痫是否安全合理。方法 以目前较普遍接受的卡马西平 (CBZ)治疗癫痫的有效血药浓度 4～ 10mg L为标准 ,将两组门诊成人癫痫病人共 32例在下午 7:0 0晚餐后顿服不同剂量卡马西平 ,一组顿服CBZ30 0mg,另一组顿服CBZ2 0 0mg ,连续顿服 10天 ,分不同时段采集血液标本 ,采用高效液相色谱仪 (HPLC)监测其血清卡马西平浓度。并予以有效血药浓度为标准进行统计学处理。结果 维持夜间最低有效浓度的剂量不宜低于 30 0mg,其维持时间约 7h(晚上 11:0 0～次晨早上 6 :0 0 ) ,而 2 0 0mg不能维持有效浓度。结论 睡前顿服CBZ30 0mg治疗夜间发作性癫痫从有效血药浓度上考虑是可行。

Objective To discuss safety and reasonability of once-daily adult optimal dosage of CBZ for the treatment of nocturnal seizure.Methods This project is based on a generally received standard at present that the serum concentration of 4～10 mg/L of CBZ is effective for the treatment of epilepsy.After having nonliquid food after supper and taking CBZ of different dosage at 7 pm. for 10 days ,two groups total 32 adult epileptic outpatients were undergone blood-drawing for monitoring their serum concentration with high-performance liquid chromatography(HPLC) in order to find out and recommend an optimal dosage for maintaining the effective serum concentration during night for those patients with nocturnal seizure.Results The dosage can not be less than 300 mg for maintaining therapeutic serum concentration during night. This concentration can be maintained for 7 hours (11 pm.～6 am.),but can't be maintained when the CBZ dosage is 200 mg.Conclusions It is available to use this method that once-daily treatment nocturnal seizure in CBZ 300 mg considering serum cocentration.