348例次癫痫儿童丙戊酸血药浓度回顾性研究.docVIP

348例次癫痫儿童丙戊酸血药浓度回顾性研究[摘要] 目的：为癫痫儿童丙戊酸钠的合理用药提供参考。方法：采用程序升温气相色谱法对348例次癫痫儿童服用丙戊酸钠进行血药浓度监测，并对血药浓度结果与剂型、合并用药、临床疗效的关系进行分析总结。结果：使用丙戊酸钠缓释片的癫痫患儿其血药浓度偏高；卡马西平可使丙戊酸的血药浓度降低；丙戊酸有效血药浓度的范围较大。结论：丙戊酸血药浓度监测对癫痫儿童合理用药有重要的指导作用，血药浓度个体差异较大，临床用药时需个体化给药。 [关键词] 程序升温气相色谱法；丙戊酸；血药浓度监测 [中图分类号] R742.1[文献标识码]C [文章编号]1673-7210（2008）08（b）-064-03 Retrospective analysisof serum concentrations of valproic acid of 348 epileptic children ZHOU Jun, MEI Yan, SONG Xin-wen (Children’s Hospital of Wuhan,Hubei Province,Wuhan430016,China) [Abstract] Objective: To give some information about rationally administrating valproic acid for epileptic children. Methods:Concentrations of valproic acid in serum of 348 epileptic children were detected by capillary colum gas chromatography with a rising column temperature program,and analyzed the relationships of serum concentration with dose types,clinical effects and the combination medication. Results:The serum concentrations of epileptic children who took retard tablets were higher,and the combination medication of carbamazepine could decrease the serum concentration of valproic acid.The effective serum concentration range of valproic acid was relatively wide. Conclusion:Monitoring of serum concentration of valproic acid is of great importance in rationally administrating valproic acid for epileptic children,and the individual differences of serum concentration is large.It is suggested that an individual administrated scheme should be applied in clinical practice. [Key words] Capillary colum gas chromatography with a rising column temperature program; Valproic acid;Monitoring of serum concentration 丙戊酸钠（sodium valproate,VPA）是儿科常用的广谱抗癫痫药物，对各型癫痫发作均有效，尤其对于儿童典型失神发作最有效。我院目前已将丙戊酸钠作为一线抗癫痫药物广泛应用于临床各种癫痫的治疗。但丙戊酸钠的体内过程和疗效存在较大的个体差异，给药剂量和血药浓度相关性不稳定，因此，血药浓度监测对于判断丙戊酸钠的临床疗效，调整给药剂量，减少副作用非常必要[1]。本文对近4年来348例次癫痫儿童服用丙戊酸钠的血药浓度监测结果进行回顾性分析，为临床合理用药提供依据。 1资料与方法 1.1一般资料 2003～2006年，在我院门诊及住院的癫痫患儿服用VPA并测定血药浓度共348例次，服药剂量为15～40 mg/（kg?d）。其中，男218例次，女130例次；年龄6个月～16岁。单用VP