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目的:评价儿童癫痫患者卡马西平(CBZ)血药浓度的监测结果,分析其影响因素,为临床合理用药提供参考。方法:选择2010年5月-2015年5月徐州市儿童医院与徐州医学院附属医院监测CBZ血药浓度的儿童癫痫患者2 703例,采用酶放大免疫法测定其血清中CBZ的浓度,分析患儿年龄、性别、联合用药等因素对CBZ血药浓度的影响。结果:2 469例使用单药治疗的患儿中,CBZ血药浓度在有效范围(4~12μg/ml)内的有1 939例(占78.53%);各年龄段患儿CBZ平均血药浓度分别为(4.97±2.55)(0~3岁)、(6.18±2.55)(4~6岁)、(7.04±2.56)(7~14岁)、(8.26±3.32)(15~<18岁)μg/ml,差异有统计学意义(P<0.05);不同性别患儿CBZ平均血药浓度间的差异无统计学意义(P>0.05)。234例联合丙戊酸钠治疗的患儿中,CBZ血药浓度<4μg/ml患儿的比例(27.35%)高于单药治疗的患儿(18.96%),其平均血药浓度[(2.87±1.00)μg/ml]低于单药治疗的患儿[(3.36±0.97)μg/ml],差异均有统计学意义(P<0.05)。结论:儿童癫痫患者CBZ血药浓度与年龄、联合用药等因素相关。在制订给药方案时,应结合患儿的年龄调整给药剂量;联合用药应在血药浓度监测的基础上进行。
Objective: To evaluate the monitoring results of plasma concentration of carbamazepine (CBZ) in children with epilepsy and to analyze its influential factors, so as to provide a reference for clinical rational drug use. Methods: A total of 2 703 children with epilepsy were collected from May 2010 to May 2015 in Xuzhou Children’s Hospital and Xuzhou Medical College Affiliated Hospital. Serum concentrations of CBZ were measured by Enzyme-Enrichment Immunoassay Children age, gender, combination therapy and other factors on CBZ blood concentration. Results: Among 2 469 children treated with monotherapy, there were 1 939 (78.53%) patients with CBZ within the effective range (4 ~ 12μg / ml), mean CBZ mean plasma concentration (4.97 ± 2.55) (0-3 years), (6.18 ± 2.55) (4-6 years), (7.04 ± 2.56) (7-14 years) and (8.26 ± 3.32) (15-18 years) μg / ml, the difference was statistically significant (P <0.05). There was no significant difference between the mean blood concentration of CBZ in different sexes (P> 0.05). Among the 234 patients treated with sodium valproate, the mean plasma concentration of CBZ (27.35%) was higher than that of monotherapy (18.96%) [(2.87 ± 1.00) μg / ml] was lower than that of monotherapy group [(3.36 ± 0.97) μg / ml], the differences were statistically significant (P <0.05). Conclusion: CBZ blood concentration in children with epilepsy is related to age, combination therapy and other factors. In the development of drug delivery programs, should be combined with the age of children to adjust the dose; combination should be based on blood concentration monitoring.