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目的 研究单用卡马西平(CBZ)治疗癫痫部分性发作患者最佳血药浓度和合用丙戊酸钠(VPANa)时对CBZ血浓度的影响。方法 采用高效液相色谱法对80例癫痫部分性发作患者测定稳态时血CBZ浓度,其中单服CBZ67例,合并丙戊酸钠13例。并对测定结果与临床疗效的关系进行分析。结果 血CBZ浓度在9～109mg·L-1时控制临床发作的显效率及控制率最高;血CBZ浓度在11～12mg·L-1时脑电图好转率及基本正常率最高,但与血CBZ浓度9～109mg·L-1时脑电图好转率及基本正常率相比差异无显著性(P>005)。临床毒副作用发生率以血CBZ浓度11～12mg·L-1时最高。合用VPANa组血CBZ浓度低于单用CBZ组血浓度(P<001)。结论 卡马西平治疗癫痫部分性发作的最佳血药浓度为9～109mg·L-1,合用VPANa可降低血CBZ浓度。
Objective To investigate the effect of CBZ on the blood concentration of CBZ in patients with partial seizures and VPANa alone. Methods Eighty patients with partial epilepsy were enrolled in this study. Plasma concentrations of CBZ were measured at steady state, including 67 cases of single-serving CBZ and 13 cases of sodium valproate. And the relationship between the measurement results and clinical efficacy were analyzed. Results The effective rate and control rate of CBZ at 9-109 mg · L-1 were the highest. The improvement rate and basic normal rate of CBZ at CBP concentration of 11 ~ 12 mg · L-1 were the highest, CBZ concentration 9 ~ 109mg · L-1 EEG conversion rate and the basic normal rate was no significant difference (P> 005). The incidence of clinical side effects with blood CBZ concentration of 11 ~ 12mg · L-1 highest. The plasma concentration of CBZ in VPANa group was lower than that in CBZ group (P <001). Conclusion The optimal concentration of carbamazepine for partial epileptic seizures is 9-109 mg · L-1, and the combination of VPANa can reduce the blood CBZ concentration.