癫痫患者拉莫三嗪血药浓度与疗效及剂量关系的研究  

Study on the relationships between plasma lamotrigine concentration and effectiveness and the dose- response relationship in epileptic patients

作　　者：陈晓燕[1] 张鹏[2] 何学仙 刘西银 李怡[1] 王振海 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学总医院药剂科,宁夏银川750004 [3]宁夏颅脑疾病重点实验室,宁夏银川750004

出　　处：《宁夏医学杂志》2014年第4期305-307,共3页Ningxia Medical Journal

基　　金：国家自然科学基金资助项目(81160151)

摘　　要：目的 分析癫痫患者拉莫三嗪（LTG）血药浓度与疗效及剂量的关系.方法 收集宁夏医科大学总院门诊及住院部60例单服LTG治疗癫痫的患者,采集空腹血5 mL,运用高效液相色谱法（HPLC）测得LTG血药浓度,依据LTG血药浓度将60例患者分为偏低浓度（＜1 μg·mL14例）、有效浓度（1～8μg·mL-149例）及偏高浓度（＞8 μg·mL-17例）3组进行分析.结果 检测结果显示49例患者LTG血药浓度在1～8 μg·mL-1,其中有43例LTG服用剂量50～200 mg,有87.8％的患者癫痫发作得到有效控制;LTG对癫痫各类型发作疗效显著,对全面性发作尤为明显,在血药浓度为1 ～8 μg·mL-1时,LTG对全面性发作与部分性发作有效率差异有统计学意义（P＜0.05）.结论 LTG治疗多种癫痫类型疗效明显,血药浓度在1～8 μg·mL-1时,对全面性发作疗效更好;临床上LTG给药剂量控制在50～200 mg,为相对安全有效的剂量范围.Objective To analyze the relationship between plasma lamotrigine concentration and effectiveness and the dose - response relationship in epileptic patients. Methods 60 patients with epilepsy who only had lamotrigine in the General Hospital of Ningxia Medical University were selected to collect 5mL fasting blood samples respectively. The cases were divided into three groups： low concentration group （ 〈 1 μg · mL- 1, n = 4 ）, effective concentration group （ 1 - 8 lug · mL-1, n = 49 ） and high concentration group （ 〉 8 μg · mL-1, n = 7 ）, according to the results of lamotrigine concentration detected by high performance liquid chromatographic （HPLC）. Results There were 49 epilepsy cases whose lamotrigine concentration were between the range of 1 - 8 ·mL-1 ,43 cases taking a dosage of 50 mg- 200 mg, 87.8% seizures cases controlled effectively. LTG had a significant efficacy in the treatment of various types of epilepsy, particularly in the tape of generalized seizures. LTG therapeutic effect had a significant difference between partial sei- zures and generalized seizures （P 〈 0.05） when the concentration maintained the range of 1 - 8 · mL-1. Conclusion LTG thera- peutic effect has a significant difference between partial seizures and generalized seizures （P 〈 0.05 ） when the concentration maintained the range of 1 - 8 μg · mL- 1. LTG dosage should be controlled between the safe and effective range of 50 mg - 200 mg clinically.

关 键 词：拉莫三嗪 血药浓度 临床疗效 副反应 

分 类 号：R742.1[医药卫生—神经病学与精神病学]