目的：研究丙戊酸钠血药浓度与抗癫痫疗效及影响因素的关系，为临床个体化用药指导提供依据。方法对重庆医科大学附属永川医院133例服用丙戊酸钠的患者进行血药浓度测定，对血药浓度监测结果进行统计分析，并对133例患者抗癫痫疗效进行观察及分析。结果80例患者癫痫得到了控制，占60．15％，有效血药浓度（50～100 m g／L ）范围内有51例患者癫痫得到控制，占38．35％。血药浓度小于50 m g／L的44例患者中，26例未得到控制；男性与女性的血药浓度分布相似；丙戊酸钠血药浓度在各年龄组之间存在差异，成年组有52．87％患者血药浓度低于或高于治疗范围，未成年组则有39．13％；随着血药浓度增加，不良反应增加。结论丙戊酸钠的血药浓度与患者抗癫痫疗效之间存在个体差异，临床应用时，应根据患者的丙戊酸钠血药浓度、癫痫控制情况及年龄进行合理的个体化给药。%Objective To investigate the relationship between blood concentration of sodium valproate and the anti‐epileptic effect and the influencing factors of blood concentration of sodium valproate ,and to provide evidence for clinical individual adminis‐tration .Methods The blood concentrations of 133 cases of patients treated with sodium valproate were determined in the affiliated Yongchuan hospital of Chongqing medical university ,the monitoring results of blood concentration were statistically analyzed ,and the anti‐epileptic effect of 133 cases of patients were observed and analyzed .Results The epilepsy of 80 cases of patients were con‐trolled ,accounted for 60 .15% of the total number;in the 69 cases of patients within the effective blood drug concentration (50-100 mg/L) ,the epilepsy of 51 cases of patients were controlled ,accounting for 38 .35% .In the 44 cases of patients whose blood drug concentration were less than 50mg/L ,the epilepsy of 26 cases of patients were not controlled .The distribution of blood concentra‐tion between men and women were similar .The blood concentrations among each age group were different ,the blood concentrations of 52 .87% patients in the adult group were below or above therapeutic range that were 39 .13% in the minor group .The adverse reactions were increase with the increase of blood concentration .Conclusion There are differences between the blood concentrations of sodium valproate and clinical effect ,the reasonable individual administration should be conducted according to the patient′s blood concentrations of sodium valproate ,the epilepsy control situation of patients and the patients′age .
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