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目的了解癫痫患儿服用丙戊酸(VPA)、卡马西平(CBZ)的血药浓度监测情况,为临床合理用药提供参考。方法2007年1月至2008年12月于遵义医学院附属医院采用荧光偏振免疫法(FPIA),测定758例癫痫患儿VPA和CBZ的血药浓度谷值,并就监测的结果进行分析。结果共监测1106例次癫痫患儿血药浓度,口服VPA在有效血药浓度范围以内的有477例次(477/821,58.1%);口服CBZ在有效血药浓度范围以内的有202例次(202/285,70.9%);联合用药129例次,在有效血药浓度范围以内的有65例次(65/129,50.4%)。结论患儿血药浓度个体差异大,联合用药时相互作用复杂,定期进行血药浓度监测,对实施个体化给药,提高疗效和确保用药安全具有十分重要的临床意义。
Objective To understand the monitoring of plasma concentration of valproic acid (VPA) and carbamazepine (CBZ) in children with epilepsy and provide a reference for clinical rational drug use. Methods From January 2007 to December 2008 at the Affiliated Hospital of Zunyi Medical College, the plasma concentration valleys of VPA and CBZ in 758 epilepsy children were measured by fluorescence polarization immunoassay (FPIA), and the results of monitoring were analyzed. Results A total of 1106 children with epilepsy were monitored for plasma concentrations of 477 (477 / 821,58.1%) oral VPA within the effective plasma concentration range; oral CBZ within the effective plasma concentration range of 202 cases (202/285 and 70.9%). The combined treatment of 129 cases, 65 cases (65 / 129,50.4%) within the effective plasma concentration range. Conclusions There is a large individual difference in serum concentration of drug in children with complicated interactions during combination therapy. Regular monitoring of plasma concentration is of great clinical significance for individualized administration, improvement of efficacy and safety of medication.