Objective To discuss the serum concentration of sodium valporate and clinical response,to found the best medication method, improve therapeutic level. Methods Serum concentration of sodium valporate and clinical situation of 419 patients were collected and analyzed. Results The control rate of sodium valproate was 47.4% ~ 63. 8% within the valid range of AEDs concentration 50 ~ 110 mg/L ),there was a low association between clinical response and AEDs concentration for epielpsy patients. When plasma concentration was more than 110 mg/L,the control rate was lower. The adverse reactions happened in both group, and with the increase of the concentration, the rate was likely to rise. Patients who took sustained release tablets had more likely ADR than others. The average serum concentration of sodium valporate was 53. 3 mg/L in 0 ~ 3 year-old group,64. 9 mg/L in 60 year-old group. There was no significant difference between the two groups. Conclusion There are many factors to affect serum concentration of sodium valporate,such as physiology and pathology of the disease,dosage form,combined medications,etc. Therefore,physician should consider all of these factors in clinic.%目的 探讨丙戊酸钠的浓度与疗效及不良反应等各因素的关系,寻找最佳给药方案,提高临床治疗水平.方法 收集病例资料,选取419例次丙戊酸钠血药浓度结果与临床情况进行分析.结果 当血药浓度为50~110 mg/L时,控制率为47.4%~63.8%,疗效与血药浓度呈低度相关;当浓度高于110 mg/L时,控制率下降.不良反应在各阶段浓度范围内均有发生,随着浓度增加,发生率逐渐增加.缓释剂组血药浓度明显高于口服液组及普通片组.各年龄组血药浓度:0~3岁组平均53.3 mg/L(略低),60岁组64.9 mg/L(略高),各年龄组疗效差异无统计学意义.结论 影响丙戊酸钠血药浓度及其疗效的因素众多,临床使用丙戊酸钠应充分考虑患者生理、病理、不良反应、剂型及合并用药等多方面因素.
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