某院4580例抗癫痫药血药浓度监测数据分析  

Retrospective Analysis of Therapeutic Drug Monitoring on 4580 Cases of Anti-epilepsy Drug in A Hospital

作　　者：李佳[1] 闫佳佳[1] 何秋毅[1] 许晨舒[1] 梁嘉俊[1] 任斌[1] 

机构地区：[1]中山大学附属第一医院药学部,广东广州510080

出　　处：《今日药学》2013年第5期302-306,共5页Pharmacy Today

摘　　要：目的分析总结本院近3年来抗癫痫药物血药浓度监测结果,以指导临床合理用药。方法运用回顾性调查方法,对2010-01～2012-12本院4种常用的抗癫痫药血药浓度监测结果共4 580例次进行分析。结果 4种抗癫痫药物的血药浓度在治疗窗内所占比例为54.72%,低于治疗窗的为38.97%,高于治疗窗的为6.31%;苯巴比妥、苯妥英、丙戊酸、卡马西平血药浓度在治疗窗内的比例分别为40.54%、16.62%、54.25%、77.22%,具有统计学差异(P<0.05)。丙戊酸使用率最高,为70.83%,其血药浓度存在性别差异(P<0.05)。苯妥英、丙戊酸、卡马西平血药浓度存在年龄差异(P<0.05)。结论血药浓度监测结果是指导临床用药的依据之一,血药浓度不在治疗窗内的原因很多,应结合其他临床指标综合分析监测结果,以最大限度地保证抗癫痫药的合理应用。Objective To analyze the therapeutic drug monitoring data on antiepileptic drugs（AEDs） to provide guidelines for rational application of AEDs in clinical practice.Methods The plasma concentration results of 4 580 cases of AEDs from 2010 to 2012 were analyzed retrospectively.Results 54.72% of the 4 580 cases fell within the therapeutic window,whereas 38.97% were below the therapeutic threshold and 6.31% were above the therapeutic ceiling.The percentages of the plasma concentration of AEDs within the effective ranges were 40.54%,16.62%,54.25%,and 77.22% for phenobarbital,phenytoin,valproate,and carbamazepine,respectively,all of which presented with significant difference（P0.05）.The application rate of valproate was 70.83%,highest among the 4 drugs.Moreover,the plasma concentration of valproate showed significant difference between the genders（P0.05）.The plasma concentrations of phenytoin,valproate,and carbamazepine had significant difference between different ages（P0.05）.Conclusion Therapeutic drug monitoring plays an important role in rational drug application.Various factors contribute to the phenomenon that plasma concentration falls beyond the therapeutic window.Therefore,different clinical indications should be included to evaluate the efficacy of anti-epilepsy drugs.

关 键 词：抗癫痫药物 血药浓度监测 回顾性分析 

分 类 号：R97[医药卫生—药品]