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目的:监测丙戊酸钠缓释片治疗不同年龄段癫痫患者的血药浓度,并对数据进行分析,为临床合理用药提供参考。方法:2013年1月-2015年12月,收治癫痫患者123例,其中成人41例(成人组),儿童60例(儿童组),老人22例(老人组);3组均用丙戊酸钠缓释片规律治疗(20~30 mg·kg-1·d-1,1~2次/d,po),并采用高效液相色谱法进行血药浓度测定。结果:丙戊酸钠缓释片治疗儿童、成人、老人癫痫疗效肯定(有效率分别达80.00%,95.12%与95.45%);药品不良反应(ADR)与血药浓度间有统计学意义(P<0.05),且当血药浓度>100 mg·L-1时ADR明显增多,达60.00%;3组间比较ADR发生情况无统计学意义(P>0.05);在降低各类型癫痫发作频次、疗效方面和血药浓度控制方面成人组和老人组均优于儿童组(P<0.05)。结论:丙戊酸钠缓释片治疗儿童、成人和老人癫痫均有效,但仍存差异。丙戊酸钠缓释片治疗成人和老人癫痫是适宜的,但对于年龄偏小的儿童来说并不是最好的,此为临床用药提供参考。不良反应随血药浓度上升而明显增多,临床用药时应注意血药浓度监测。
OBJECTIVE: To monitor the plasma concentration of sodium valproate sustained-release tablets in patients with epilepsy at different ages and analyze the data to provide reference for clinical rational drug use. Methods: From January 2013 to December 2015, 123 cases of epilepsy were treated, including 41 adults (adult group), 60 children (children group) and 22 elderly people (elderly group). All three groups were treated with valproic acid Sodium sustained release tablets regular treatment (20 ~ 30 mg · kg-1 · d-1,1 ~ 2 times / d, po), and the determination of plasma concentrations of high performance liquid chromatography. Results: The efficacy of sodium valproate sustained-release tablets in treatment of epilepsy in children, adults and the elderly was positive (the effective rates were 80.00%, 95.12% and 95.45% respectively); there was a significant difference between ADR and plasma concentration (P (P <0.05), and ADR increased significantly when the plasma concentration was> 100 mg · L-1, up to 60.00%. There was no significant difference in ADR among the three groups (P> 0.05). In reducing the frequency of all types of seizures, Efficacy and blood concentration control adult and elderly groups were better than children (P <0.05). Conclusion: Sodium valproate sustained-release tablets in children, adults and the elderly are effective epilepsy, but still exist differences. Sodium valproate sustained-release tablets for the treatment of adult and elderly epilepsy is appropriate, but not for the younger children is not the best, which provides a reference for clinical use. Adverse reactions with the plasma concentration increased significantly increased, clinical medication should pay attention to blood drug concentration monitoring.