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目的:探讨奥卡西平治疗癫痫患者的过程中10,11-二氢-10-羟基卡马西平(MHD)的血药浓度与患者疗效及不良反应的关系。方法:选取2013年5月~2015年6月在本院接受癫痫治疗的77例患者作为研究对象,统计患者的个体信息、用药种类、剂量、不良反应的发生情况,采用高效液相色谱(HPLC)测量患者的MHD血药浓度,并分析给药剂量与MHD的关系。结果:达到控制的患者有19.48%、显效的患者有41.56%、有效的患者28.57%、无效的患者10.39%,不同疗效患者的MHD血药浓度组间比较差异均具有统计学意义;随着MHD血药浓度的提高,患者的疗效更好。采用一般线性回归计算MHD稳态模型:MHD=0.286×给药剂量(mg/kg·d)+5.98,相关系数r=0.402,P<0.05。本次研究中,共有18例患者发生不同程度和类型的不良反应,不良反应发生率为23.37%,主要表现为头晕5例、疲劳5例、胃肠道不适状3例、皮疹2例、体重增加1例、其他2例,发生不良反应患者的MHD血药浓度水平显著的高于未发生不良发应患者的MHD血药浓度且差异具有统计学意义。结论:MHD血药浓度增加可以提高奥卡西平治疗癫痫患者的效果,但同时不良反应发生率增加,MHD血药浓度与给药剂量呈显著的正相关关系,建立MHD血药浓度监测有利于对患者进行个体化治疗。
Objective: To investigate the relationship between the plasma concentration of 10,11-dihydro-10-hydroxycarbamazepine (MHD) and the efficacy and side effects of oxaliplatin in patients with epilepsy. Methods: Totally 77 patients receiving epilepsy in our hospital from May 2013 to June 2015 were enrolled in this study. The individual information, medication type, dosage and adverse reactions of the patients were statistically analyzed by high performance liquid chromatography (HPLC) ) To measure the patient’s MHD plasma concentration, and analysis of the dose and MHD relationship. Results: There were 19.48% of the controlled patients, 41.56% of the effective patients, 28.57% of the effective patients and 10.39% of the invalid patients. The differences of MHD plasma concentration between the two groups were statistically significant. Blood concentration increased, the patient’s effect is better. The MHD steady-state model was calculated by general linear regression model: MHD = 0.286 × dose (mg / kg · d) +5.98, correlation coefficient r = 0.402, P <0.05. In this study, a total of 18 patients with varying degrees and types of adverse reactions, the incidence of adverse reactions was 23.37%, mainly in 5 cases of dizziness, fatigue in 5 cases, gastrointestinal discomfort in 3 cases, 2 cases of rash, body weight In 1 case and 2 cases in other cases, the level of MHD in patients with adverse reactions was significantly higher than that in patients without adverse reactions and the difference was statistically significant. Conclusion: The increase of plasma concentration of MHD can improve the efficacy of oxcarbazepine in the treatment of patients with epilepsy, but at the same time, the incidence of adverse reactions increases. There is a significant positive correlation between the plasma concentration of MHD and the dose of MHD. Patients are treated individually.