2 703例儿童癫痫患者卡马西平的血药浓度监测结果及影响因素分析
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篇名: 2 703例儿童癫痫患者卡马西平的血药浓度监测结果及影响因素分析
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摘要: 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(4~12 μg/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<4 μg/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。
ABSTRACT: OBJECTIVE: To evaluate the results of serum concentration monitoring of carbamazepine (CBZ) in pediatric epilepsy patients, analyze the infunential factors, and to provide reference for rational drug use in the clinic. METHODS: 2 703 pediatric epilepsy patients underwent CBZ serum concentration monitoring were collected from Xuzhou Children’s Hospital and the Affiliated Hospital of Xuzhou Medical College during May 2010-May 2015, and the serum concentration of CBZ was determined by enzyme amplified immunoassay. The effects of age, gender, drug combination and other factors on the serum concentration of CBZ were analyzed. RESULTS: Of 2 469 patients receiving single drug therapy, serum concentration of CBZ was 4-12 μg/ml in 1 939 cases (78.53%). The average serum concentration of CBZ was (4.97±2.55) μg/ml in children aged from 0-3 years, (6.18±2.55) μg/ml in those aged from 4-6 years, (7.04±2.56) μg/ml in those aged from 7-14 years and (8.26±3.32) μg/ml in those aged from 15-<18 years, with statistical significance (P<0.05). There was no statistical significance in average serum concentration of CBZ among different genders (P>0.05). Of 234 cases of combined use of sodium valproate, the proportion of children whose serum concentration of CBZ<4 μg/ml (27.35%) was higher than that of children receiving single drug therapy (18.96%); average serum concentration [(2.87±1.00)μg/ml] of them was lower than that of children receiving single drug therapy [(3.36±0.97)μg/ml], with statistical significance (P<0.05). CONCLUSIONS: Serum concentration of CBZ in pediatric epilepsy patients is related to age, drug combination and other factors. For therapy regimen development, drug dosage should adjusted according to age. Drug combination should carry out based serum concentration monitoring.
期刊: 2016年第27卷第11期
作者: 任玲,沐宇,姬怀雪,王艳
AUTHORS: REN Ling,MU Yu,JI Huaixue,WANG Yan
关键字: 卡马西平;儿童癫痫;血药浓度监测;影响因素
KEYWORDS: Carbamazepine; Pediatric epilepsy; Serum concentration monitoring; Infunential factors
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