游离药物浓度监测指导癫癎患者联合用药  

Effect of Serum Free-drug Monitoring in Guiding Combining Medication for Epileptic Patients

作　　者：王锦秋[1] 王民[2] 丰艳梅[1] 

机构地区：[1]西安交通大学医学院第二附属医院药剂科,710004 [2]西安交通大学药业集团,710061

出　　处：《医药导报》2012年第3期370-372,共3页Herald of Medicine

基　　金：陕西省科学技术研究发展计划项目[2006k14-G5(3)]

摘　　要：目的指导癫癎患者合理用药。方法观察西安交通大学医学院第二附属医院2007～2010年服用丙戊酸(VPA)和卡马西平(CBZ)癫癎患者3 906例,其中抽取100例监测游离药物浓度。结果 VPA和CBZ联合用药相比单一用药时,VPA浓度在有效浓度范围内的比例由72.5%降低至54.8%,CBZ浓度在有效浓度范围内的比例由58.0%增加至84.3%。单用或联合用药时,在高浓度VPA和CBZ的蛋白结合率明显下降,游离浓度增加。结论 VPA和CBZ在联合用药时要根据血药浓度监测结果调整给药剂量,在高浓度时应监测游离药物浓度。Objective To guide a reasonable medication for epileptic patients.Methods The total of 3 906 cases of epileptic patients administrated with valproic acid（VPA） and carbamazepine（CBZ） were followed up in No.2 hospital of Xi＇an Jiaotong University from 2007 to 2010,in which 100 samples were taken out for monitoring the serum free-drug concentration.Results The concentration of VPA and CBZ used in combination or alone decreased（72.5% vs 54.8%） and increased（58.0% vs 84.3%）,respectively.However,at the higher concentration,the protein biding rate was significantly reduced and the free serum level was increased.Conclusion The dosage should be adjusted according to the serum drug monitoring when VPA and CBZ were used together,and the free serum drug concentration should be under supervision at a high dose.

关 键 词：抗癫癎药物 治疗药物监测 游离药物浓度监测 

分 类 号：R971.6[医药卫生—药品] R969.3[医药卫生—药学]