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目的:分析癫痫患者丙戊酸血药浓度监测结果,为丙戊酸的合理应用提供依据。方法:采用荧光偏振免疫法测定癫痫患者丙戊酸血药浓度,并观察其临床疗效和不良反应。结果:1 460例次患者中,丙戊酸血浓度<50μg·ml~(-1)占42.7%,血药浓度在50～100μg·ml~(-1)的占54.2%,血药浓度>100μg·ml~(-1)的占3.1%。1 460例次癫痫患者的总有效率为68.01%,而且血药浓度越高,疗效越好。66～100岁组丙戊酸血浓度达到治疗窗的百分率明显低于0～18岁和19～40岁组(P<0.01)。联合用药患者的血药浓度有53.46%低于治疗窗,联合用药的159例次患者总有效率为59.12%。结论:丙戊酸的血药浓度监测可为临床医生制定个体化给药方案提供客观依据,对提高癫痫治疗的安全性、有效性有重要意义。
Objective: To analyze the monitoring results of plasma valproic acid concentration in patients with epilepsy, and to provide a basis for the rational application of valproic acid. Methods: The plasma concentration of valproate in patients with epilepsy was measured by fluorescence polarization immunoassay and the clinical efficacy and adverse reactions were observed. Results: In 1460 patients, plasma valproic acid concentration was less than 50μg · ml ~ (42.7%), plasma concentration was 50 ~ 100μg · ml ~ (54.2%), plasma concentration was> 100μg · ml -1 accounted for 3.1%. The total effective rate was 68.01% in 1 460 cases of epilepsy, and the higher the plasma concentration, the better the curative effect. The percentage of valproic acid in the treatment group reaching the therapeutic window at 66-100 years old was significantly lower than that of 0-18 years old and 19-40 years old group (P <0.01). The plasma concentration of combination therapy patients was 53.46% lower than the therapeutic window, and the total effective rate was 59.12% in 159 cases of combination therapy. Conclusion: The plasma concentration monitoring of valproic acid can provide an objective basis for clinicians to formulate individualized dosing regimens, and is of great significance to improve the safety and efficacy of epilepsy treatment.