1692例抗癫痫药物血药浓度监测结果与分析

摘要

Objective:To summarize the monitoring results on plasma concentration of four kinds of anti-epilepsy drug in the last three years in our hospital,which can provide reference for safety and rational use anti-epilepsy in clinic. Methods:The blood concentration results from 1692 cases of anti-epilepsy drug from January 2011 to May 2014 were analyzed by retrospective methods. Results:Monitoring frequency (cases per each patient) of valproate (VPA), carbamazepine (CBZ), phenobarbital (PB) and phenytoin (PHT) was 2.46、1.74、1.30 and 1.41 in their turns. The percentage of blood concentration within effective range of trough concentration of VPA, CBZ, PB and PHT was 57.23%,69.02%,22.50%,and 11.46%, respectively, What’s more, P value was lower than 0.05 and they had significant difference between each other. Toxicity rate was 8.04%, 7.09%, 17.50%and 16.67%, respectively. VPA and CBZ (P=0.584), both PB and PHT (P=0.872) didn't show significant difference in poisoning rate. While VPA and PB (P=0.001), VPA and PHT (P=0.004) both had significant difference in poisoning rate. CBZ and PB (P=0.001), CBZ and PHT (P=0.003) also showed significant difference in poisoning rate. Conclusion:Monitoring frequency of VPA and CBZ was higher than PB and PHT, while poisoning rate was lower than PB and PHT.%目的：总结我院近3年4种抗癫痫药物的血药浓度监测结果，为临床安全、合理应用抗癫痫药物提供参考。方法：运用回顾性研究方法对我院2011年1月～2014年5月共1692例抗癫痫药物监测数据进行分析。结果：丙戊酸钠(valproate，VPA)、卡马西平(carbamazepine，CBZ)、苯巴比妥(phenobarbital，PB)和苯妥英钠(phenytoin，PHT)的监测频率(例/人)分别为2.46、1.74、1.30和1.41。V PA、C B Z、P B和P H T谷浓度在有效浓度范围内的比例分别是57.23%、69.02%、22.50%和11.46%，(P<0.05)，两两之间均存在显著性差异；其中毒率分别是8.04%、7.09%、17.50%和16.67%，V PA和C B Z(P=0.584)，P B和P H T(P=0.872)均不存在显著性差异，而V PA和P B(P=0.001)，V PA和P H T(P=0.004)之间均存在显著性差异，C B Z和P B(P=0.001)，V PA和PHT(P=0.003)之间也存在显著性差异。结论：VPA和CBZ监测频率高于PB和PHT，中毒率低于PB和PHT。