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目的 :研究社区人群癫患者药物治疗现状及影响其效果的主要因素。方法 :于 2 0 0 0年在上海市金山朱泾镇采用分层整群抽样完成 5万人群的癫普查 ,并对癫患者进行药物治疗现状调查和对服药者的血药浓度进行测定。结果 :癫患病率为 3 11‰ ,标化患病率为 3 6 2‰。癫患者中从未服药者 33 1% ,曾服药者 6 6 9% ,目前正在服药者占 35 6 % ,以单药治疗为主。治疗后显效者5 1 5 % ,有效者 4 0 6 % ,无效或恶化者 7 9%。服用单药者显效和有效的比例明显高于服用二种药或三种药的效果。服药者血药浓度在有效范围者 ,仅占 36 1% ,其中服用苯巴比妥者血药浓度达标的比例(71 4 % ) ,明显高于其他药物。血药浓度在有效范围内的显效率为 5 3 3% ,明显高于未达有效范围者的显效率 (2 3 8% )。非条件Logistic回归分析显示与治疗效果有关的主要因素为病程、发作年龄、现年龄、发作频率、教育程度、服药类型、血药浓度等。结论 :社区人群癫患者接受治疗的比例和服药后血药浓度达有效范围的比例都较低。治疗效果受多种因素影响
Objective: To study the status quo of drug treatment in epilepsy patients in community population and the main factors that affect their effect. Methods: A total of 50,000 population epilepsy censuses were performed in stratified cluster sampling in Zhujing Town, Jinshan City, Shanghai 2000, and the status of drug treatment in epileptic patients and the plasma concentration of the drug were measured . Results: The prevalence of epilepsy was 3 11 ‰, and the standardized prevalence was 362 ‰. Among those with epilepsy, 33.1% never took medication, 66.9% had medication, and 35.6% are currently taking medication, mainly taking monotherapy. After treatment markedly 51 1%, effective 46%, invalid or worsening 7 9%. Significantly effective and effective than taking a single drug was significantly higher than taking two or three drugs. Only 36.1% of the patients took their blood drug concentration in the effective range. The proportion of patients taking phenobarbital reached the standard (71.4%), which was significantly higher than that of other drugs. The effective rate of plasma concentration in the effective range was 53.3%, which was significantly higher than that in the lower effective range (23.8%). Non-conditional Logistic regression analysis showed that the main factors related to the treatment effect were the course of disease, the age of onset, the age of onset, the frequency of seizure, education, medication type and plasma concentration. CONCLUSIONS: The proportion of patients receiving epilepsy in community population and the effective range of plasma concentration after taking the drug is low. Therapeutic effects are affected by many factors