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目的 :研究氯硝西泮 (clonazepam ,CZP)对丙戊酸钠 (sodiumvalproate ,VPA)的药代动力学及药效学的影响。方法 :采用定量药物脑电图 (QuantitativePharmaco EEG ,QPEEG)的方法 ,观察了 4例长期服用VPA无效的全身性癫痫发作的患儿 ,一次性给予CZP后 ,在即刻 ,0 .5 ,1,1.5 ,2 ,3 ,4 ,8,12 ,2 4h分别取血 ,测VPA及CZP的血浓度 ,同时采集脑电信号 ,做功率谱分析。结果 :CZP对VPA的稳态血浓度没有影响 ;CZP主要使脑电的快波活动增多 ,而VPA血浓度与脑电各频段相对频率之间无相关性。结论 :用QPEEG研究精神神经系统药物的药代动力学与药效学的量效关系 ,是一种稳定、可靠、无创伤性的好方法。
Objective: To study the effect of clonazepam (CZP) on the pharmacokinetics and pharmacodynamics of sodium valproate (VPA). Methods: Quantitative pharmacological electroencephalogram (Quantitative Pharmaco EEG, QPEEG) method was used to observe the 4 cases of long-term VPA ineffective generalized seizures in children, a one-time administration of CZP, at immediate, 0.5, 1, 1.5 , 2, 3, 4, 8, 12, and 24 hours respectively. Blood concentrations of VPA and CZP were measured. EEG signals were collected and power spectrum analysis was performed. Results: CZP had no effect on the steady-state blood concentration of VPA; CZP mainly increased the fast wave activity of EEG, while there was no correlation between VPA blood concentration and relative frequency of EEG. CONCLUSION: QPEEG is a good, stable, reliable and noninvasive method to study the pharmacokinetics and pharmacodynamics of psycho-nervous system drugs.