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目的:探讨新疆地区汉族、维吾尔族、回族、哈萨克族癫痫患者丙戊酸钠(VPA)血药浓度的差异性。方法:选取2011-2013年在我院确诊为癫痫的门诊及住院患者中严格按照说明书剂量长期(>1周)服用VPA且未联用肝药酶诱导或抑制剂等相关药物的癫痫患者共3 002例,其中汉族1 482例、维吾尔族1 169例、回族154例、哈萨克族197例,采用荧光偏振免疫法测定稳态血药浓度,以50~100μg/m L为治疗窗(有效浓度),按年龄段0~3岁、4~17岁、18~65岁分别分析其民族差异性。结果:汉族和维吾尔族、回族0~3岁患儿达治疗窗比例分别为60.3%、48.0%、46.0%,达中毒浓度(>100μg/m L)比例分别为1.2%、7.0%、8.0%,差异均有统计学意义(P均<0.05);汉族和维吾尔族4~17岁患儿达治疗窗比例分别为69.0%、48.6%,达中毒浓度比例分别为11.0%、13.0%,差异均有统计学意义(P均<0.05);其余同年龄阶段的结果按民族类别两两比较差异均无统计学意义(P均>0.05)。结论:新疆地区汉族癫痫患儿血药浓度达治疗窗比例高于维吾尔族、回族患儿,达中毒浓度比例低于维吾尔族、回族患儿;而新疆地区汉族、维吾尔族、回族、哈萨克族成人癫痫患者VPA血药浓度比较差异无统计学意义。
Objective: To investigate the difference of plasma concentration of valproate (VPA) among Han, Uygur, Hui and Kazakans in Xinjiang region. Methods: A total of 3 epilepsy patients who took VPA in the outpatient and hospitalized patients diagnosed as epilepsy in our hospital from 2011 to 2013 in strict accordance with the instruction manual dosage (> 1 week) and those who did not receive hepatic drug induction or inhibitor and other related drugs 002 cases, including 1 482 Han cases, 1 169 Uygur cases, 154 Hui cases and 197 Kazakh cases. Fluorescence polarization immunoassay was used to determine the steady-state plasma concentration. 50-100 μg / m L of therapeutic window (effective concentration) , According to the age of 0 to 3 years old, 4 to 17 years old, 18 to 65 years old were analyzed their ethnic differences. Results: The rates of therapeutic window of Han and Uighur children aged 0-3 years were respectively 60.3%, 48.0% and 46.0%, and the toxicant concentrations (> 100μg / m L) were 1.2%, 7.0% and 8.0% , Respectively (all P <0.05). The percentages of therapeutic window in Han and Uygur children aged 4 to 17 years were 69.0% and 48.6%, respectively, and the percentages of up to poisoning were 11.0% and 13.0% (P <0.05). The results of the same age group showed no significant difference by ethnic group (P> 0.05). Conclusion: The blood concentration of Han children with epilepsy in Xinjiang is higher than that of Uyghur, and the percentage of poisoned children in Hui nationality is lower than that of Uygur and Hui children. However, Han, Uygur, Hui and Kazak adults in Xinjiang VPA blood concentration in epilepsy patients was no significant difference.