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目的本研究旨在分析影响拉莫三嗪血药浓度的相关因素,确保药物疗效及用药安全。方法回顾性收集2011-05~2013-12期间广州市脑科医院应用拉莫三嗪患者的血药浓度检测数据。102例患者共监测153次,收集的患者数据包括患者的基本情况、生理生化指标,给药剂量、联合用药情况等。以逐步回归分析法处理收集的数据,分析各类因素是如何影响拉莫三嗪血药浓度的。结果应用逐步回归法分析影响拉莫三嗪血药浓度的各类因素,结果显示拉莫三嗪的血药浓度与给药剂量的关系最为密切,同时还与患者的肝肾功能情况、合并用药显著相关(P<0.01),其中增大剂量或加用丙戊酸钠、奥卡西平、舍曲林、氟西汀等可显著提高拉莫三嗪的血药浓度;肝肾功能减弱或加用卡马西平、奎硫平、利培酮等可明显降低血药浓度。结论影响拉莫三嗪血药浓度的因素较多,需关注联合用药情况,加强拉莫三嗪的血药浓度监测,以确保疗效,减少毒副反应的发生。
Purpose The purpose of this study was to analyze the factors that influence the plasma concentration of lamotrigine and to ensure its efficacy and safety. Methods The data of serum concentration of lamotrigine in Guangzhou Brain Hospital from 2011-05 to 2013-12 were retrospectively collected. A total of 102 patients were monitored 153 times, the patient data collected include the basic situation of patients, physiological and biochemical indicators, the dose, the combination of medication and so on. The data collected were processed by stepwise regression analysis to analyze how various factors affected lamotrigine plasma concentrations. Results The stepwise regression analysis of various factors affecting the concentration of lamotrigine plasma results showed that the blood concentration of lamotrigine and administered dose the most closely related to the patient’s liver and kidney function, combined with medication (P <0.01). Increasing dose or adding sodium valproate, oxcarbazepine, sertraline and fluoxetine could significantly increase the plasma concentration of lamotrigine; With carbamazepine, quetiapine, risperidone can significantly reduce blood concentration. Conclusions There are many factors affecting the concentration of lamotrigine in blood. It is necessary to pay more attention to the combination therapy and monitor the blood concentration of lamotrigine to ensure the curative effect and reduce the side effects.