拉莫三嗪联合丙戊酸钠治疗维吾尔族与汉族癫（痫）患儿的差异性研究  

Differences of using lamotrigine combined with valproate treating Uygur and Han children suffering from epileptic

作　　者：李红健[1] 于鲁海[1] 孙岩[2] 刘文丽[1] 王晓雯[2] 蒋玉凤[1] 于爱平[1] 

机构地区：[1] 新疆维吾尔自治区人民医院药学部,乌鲁木齐830001 [2] 新疆维吾尔自治区人民医院儿科,乌鲁木齐830001

出　　处：《中国医药》2015年第4期505-507,共3页China Medicine

基　　金：紫禁城国际药师论坛科研课题

摘　　要：目的 探讨拉莫三嗪联合丙戊酸钠治疗维吾尔族、汉族癫（痫）患儿在剂量、血药浓度与临床疗效及安全性上的差异.方法 将患儿按民族分为维吾尔族和汉族2个治疗组,每组30例.先用丙戊酸钠治疗,20 ～ 30 mg/（kg·d）,分2次服用,仍不能控制的按照药品说明书加用拉莫三嗪治疗,1 ～5 mg/（kg·d）,分2次服用,在达到维持剂量并稳定服用后进行检测,观察临床疗效（发作频率）及不良反应（皮疹、血常规及肝、肾功能等）发生情况.结果 维吾尔族、汉族癫（痫）患儿服用丙戊酸钠的用药剂量[（28±11）、（30±10） mg/（kg· d）]与血药浓度[（61±22）、（74±26） mg/L]相关性较差（P＞0.05）,拉莫三嗪的用药剂量[（2.9±2.3）、（3.9±1.6）mg/（kg·d）]与血药浓度[（3.0±2.5）、（5.4±3.4） mg/L]相关性较好（P＜0.05）.维吾尔族、汉族癫（痫）患儿组拉莫三嗪与丙戊酸钠的用药剂量差异无统计学意义（P＞0.05）,但血药浓度差异有统计学意义（P＜0.05）,维吾尔族、汉族癫（痫）患儿组总有效率分别为76.7％ （23/30）、83.3％（25/30）,差异无统计学意义（P＞0.05）.治疗观察期内发生药物不良反应2例.结论 拉莫三嗪和丙戊酸钠联合治疗维吾尔族、汉族癫（痫）患儿疗效好且差异无统计学意义,不良反应轻微,但在治疗时应密切监测血药浓度和患儿的病情,以便更好地控制癫（痫）发作.Objective To explore the clinical efficacy, safety, dosage and blood drug concentration of lamotrigine （LTG） combined with valproate （VPA） between Uygur and Han children with epilepsy. Methods Totally 30 Uygur children and 30 Han children with epilepsy were enrolled. All the patients were administrated with VPA and LTG. The clinical effects （seizure frequency） and adverse drug reactions （including skin rashes, changes of blood routine, liver and renal function） were observed. Results In both Uygur and Han children, the correlation between dosage [ （28 ± 11 ）, （ 30 ± 10 ） rag/（ kg·d ） ] and blood drug concentration [ （ 61 ± 22 ）, （74 ±26）mg/L] was poor with VPA （r =0. 319, 0. 150, both P 〉0.05）, and the correlation between dosage [ （2.9 ± 2.3 ）, （ 3.9 ± 1.6） mg/（ kg·d） ] and blood drug concentration [ （ 3.0 ± 2.5 ）, （ 5.4 ± 3.4 ） mg/L ] was good with LTG （r = 0. 639, 0. 598, both P 〈 0.05 ）. There were no statistical differences of dosage, but there were statistical differences of blood drug concentration of VPA and LTG between Uygur and Han children （ P 〈 0.05）. The total effective rate in Uygur and Hart children was 83.3% （25/30） and 76.7% （23/30）, without a statistical difference （ P 〉 0.05 ）. Adverse drug reaction occurred in two Han children during the observation peri- od. Conclusion The curative effect of LTG combined with VPA treating epileptic has no significant difference be- tween Uygur and Han children and the adverse drug reactions are few.

关 键 词：拉莫三嗪 丙戊酸钠 癫(痫)患儿 

分 类 号：R745[医药卫生—神经病学与精神病学]