论文部分内容阅读
目的通过考查患儿对血药浓度监测的依从性,评价丙戊酸钠用药的有效性及安全性,为癫痫患儿的个体化用药提供参考。方法收集应用丙戊酸钠单用药或联合其他抗癫痫药治疗,并进行丙戊酸血药浓度监测的患儿病例,对资料进行回顾性分析。结果共有1 507例患儿纳入研究。49.44%患儿只测定了1次丙戊酸血药浓度,测定4次以上血药浓度的患儿仅占5.24%;首次进行丙戊酸血药浓度监测患儿的达治疗窗率仅为51.63%,超治疗窗者占3.58%;不同监测次数之间患儿年龄、日给药剂量、血药浓度、控制率差异均有统计学意义(P<0.05);不同年龄组之间丙戊酸血药浓度差异有统计学意义(P<0.001);丙戊酸钠单用组与合并用药组之间日给药剂量(P<0.001)、血药浓度(P=0.001)、达治疗窗率(P=0.004)有统计学差异;而不同监测次数之间,肝功能异常发生率无差异。结论丙戊酸血药浓度个体间差异大,需定期监测血药浓度,进行个体化给药,降低不良反应的发生,提高药物疗效。
Objective To evaluate the efficacy and safety of sodium valproate in children by examining the compliance of plasma concentration monitoring in children and provide reference for individualized medication in children with epilepsy. Methods The patients were treated with sodium valproate alone or in combination with other antiepileptic drugs and the plasma concentration of valproic acid was monitored. The data were retrospectively analyzed. A total of 1 507 children were included in the study. Only 49.44% of the children were assayed once for the plasma concentration of valproic acid and only for 5.24% of the children for more than four times. The first treatment with valproic acid was only 51.63 %, And the rate of super-therapeutic window was 3.58%. There was significant difference between the different monitoring times in children’s age, daily dose, plasma concentration and control rate (P <0.05) (P <0.001). The daily dose (P <0.001) and the plasma concentration (P = 0.001) of the sodium valproate combination group and the combination group were significantly higher than those of the control group (P = 0.004). There was no difference in the incidence of abnormal liver function between different monitoring times. Conclusion The plasma concentration of valproic acid varies widely among individuals. It is necessary to monitor the plasma concentration regularly and administer it individually to reduce the incidence of adverse reactions and improve the efficacy of the drug.