血药浓度监测对颅脑术后预防使用抗癫痫药物的意义(附156例丙戊酸钠血药浓度监测结果报告)

摘要

Objective To analyze the results of 156 cases of valproic acid natricum blood concentration in our hospital from June 2006 to March 2010. Method The high performance liquid chromatogram with PAD was used to monitor the blood concentration of valproic acid natricum,the results were analysed according to the clinical efficacy, adverse drug reaction, age, dosage form and drug combination. Result The blood concentration of most patients were 50~100µg/mL,109 cases were effective(89.3%), which will increase with age increase. Conclusion Age,sex, dosage form and drug combination can significantly affect valproic acid natricum blood concentration. In order to use valproic acid natricum safely, reasonably, effectively, should use it individual according to different patients’ conditions after craniotomy.%　　目的通过对本院神经外科2006年6月至2010年3月间156例颅脑手术患者术后预防使用丙戊酸钠血药浓度监测结果分析，探讨血药浓度监测对预防颅脑手术后常规使用丙戊酸钠预防癫痫发作的意义.方法利用HPLC法测定丙戊酸钠血药浓度，并结合临床疗效、不良反应、年龄、性别、剂型、合并用药情况进行分析.结果122例患者丙戊酸钠的血药浓度维持50~100µg/mL之间，其中109例有效(89.3%)；血药浓度随着年龄的增加而增加；对于不同年龄组的患者年龄<15岁和≥55岁者肝功能受损等不良反应发生率较高.结论丙戊酸钠的血药浓度和不良反应发生率受年龄、性别、剂型、药物相互作用等因素的影响，应根据患者基本情况，通过测定血药浓度个体化使用丙戊酸钠，使丙戊酸钠在颅脑术后常规使用丙戊酸钠预防癫痫发作方面得到更安全、合理、有效的应用.