癫痫患者丙戊酸钠血药浓度的临床特点分析

Clinical Characteristics of Sodium Valproate Blood Concentration in Epilepsy Patients

关键词:  丙戊酸钠  血药浓度  影响因素  癫痫

Key words:  sodium valproate  blood concentration  risk factor  epilepsy

摘要:

目的 探讨丙戊酸钠血药浓度与患者基本情况、剂型、用法用量等特点的关系，为个体化用药方案提供参考。方法 采用均相酶放大免疫法测定丙戊酸钠的血药浓度，运用SPSS软件对数据进行统计，采用单因素分析评价影响血药浓度的相关因素及特点。结果 遂宁市中心医院住院患者丙戊酸钠血药浓度平均值高于达标浓度，日剂量、合用碳青霉烯类和肝药酶诱导剂是影响丙戊酸钠血药浓度达标情况的相关因素。不同剂型的达标率虽无显著差异，但缓释片、注射剂的达标率明显高于普通片剂。肝功能正常或轻度损伤患者的达标率为51.11%，明显高于重度损伤患者。血药浓度>100 mg·L^-1组的不良反应明显高于血药浓度<50 mg·L^-1组和50~100 mg·L^-1组。结论 住院患者丙戊酸钠血药浓度受多方面因素影响，临床药师应根据相关风险因素给出剂量调整的建议以及预防措施，有助于减少药品不良反应。

Abstract:

OBJECTIVE To explore the relationship between sodium valproate blood drug concentration and clinical manifestations such as the patient's basic situation, dosage form, usage and dosage, to provide a reference for individualized medication plan. METHODS Enzyme multiplied immunoassay technique was used to determine the plasma concentration of sodium valproate, SPSS software was used to make statistics on the data, and single factor analysis was used to evaluate the relevant factors and characteristics that affect the plasma concentration. RESULTS The average blood concentration of sodium valproate in patients in Suining Central Hospital was higher than the standard concentration. The daily dose, combined use of carbapenems and liver drug enzyme inducer were related to the influence of the blood concentration of sodium valproate in patients with epilepsy factor. Although there was no significant difference in the compliance rate of different dosage forms, the compliance rate of sustained-release tablets and injections was significantly higher than that of ordinary tablets. The compliance rate of patients with normal liver function or mild injury was 51.11%, which was significantly higher than that of patients with severe injury. The adverse drug reactions in the group with blood concentration >100 mg·L^-1 were significantly higher than those in the group with blood concentration <50 mg·L^-1 and 50-100 mg·L^-1. CONCLUSION The blood concentration of sodium valproate in hospitalized patients is affected by many factors. Clinical pharmacists should give recommendations for dose adjustment and preventive measures according to relevant risk factors, which can help reduce adverse drug reactions.