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本文报告了单用苯妥英(PHT)和联合应用卡马西平(CBZ)致中毒23例血浓度观察结果.单用PHT组17例,PHT+CBZ组6例.两组中服苯妥英钠剂量相近.经t检验无显著性差异.单药组苯妥英钠平均血浓度为46.57±11.28μg/L;联合组苯妥英钠血浓度为23.25±8.77μg/L,卡马西平日平均剂量为0.45±0.16克.平均血浓度为2.05±1.23μg/L.结果表明PHT+CBZ在常规剂量下会出现桔抗作用:CBZ会使PHT血浓度下降,会使 PHT的中毒浓度下降,在治疗浓度范围内亦可发生中毒症状;两药合用时不宜以其时的血药浓度作为调节药物剂量的参考指标,以避免发生更为严重的后果.
This article reports the results of 23 patients with PHT and CBZ poisoning, 17 patients in the PHT alone group and 6 patients in the PHT + CBZ group. The doses of phenytoin sodium were similar in both groups. The t-test showed no significant difference.The average blood concentration of phenytoin sodium in the single drug group was 46.57 ± 11.28μg / L, that in the combination group was 23.25 ± 8.77μg / L and that of carbamazepine was 0.45 ± 0.16g. The average blood concentration was 2.05 ± 1.23μg / L. The results showed that PHT + CBZ will occur in the normal dose of anti-orange effect: CBZ PHT blood concentration will decrease, will make PHT poisoning concentration decreased in the therapeutic concentration range may also occur Poisoning symptoms; two drugs should not be combined with the time of the blood concentration as a reference dose to adjust the drug to avoid more serious consequences.