癫痫患者中拉莫三嗪联合治疗转为单药治疗的血药浓度变化  

Change of Lamotrigine Blood Drug Concentration in Patients from Combination Therapy toMonotherapy

作　　者：王满利[1] 黄希顺[1] 陈晨[1] 吴天文[1] 

机构地区：[1]郑州大学第一附属医院神经内科,郑州450052

出　　处：《神经损伤与功能重建》2015年第3期204-206,共3页Neural Injury and Functional Reconstruction

摘　　要：目的:研究小剂量拉莫三嗪(LTG)与丙戊酸(VPA)联合治疗新诊断癫痫转为LTG单药治疗后的血药浓度变化。方法:选取经小剂量LTG与VPA联合治疗6个月后发作完全控制的癫痫患者35例,逐渐减掉VPA,采用LTG单药治疗,随访6个月。记录患者的癫痫发作频率、不良反应及LTG血药浓度。结果:35例患者中有2例失访,33例完成半年随访,其中转LTG单药治疗后出现癫痫发作2例(6.1%),无发作31例(93.9%);药物转换期LTG血药浓度较转单药治疗前LTG血药浓度增高(P<0.05),停用VPA1周时、单药治疗6个月时的LTG血药浓度与单药治疗前对比差异无统计学意义(P>0.05),2例复发患者发作时血药浓度与无发作患者血药浓度相比差异无统计学意义(P>0.05)。结论:LTG与VPA联用能使LTG的血药浓度加倍且临床疗效显著增强,小剂量LTG与VPA联合治疗新诊断癫痫转为LTG单药治疗时应将LTG剂量加倍。Objective： To explore the change of lamotrigine blood drug concentration in patients who were initially treated with low-dose of lamotrigine（LTG） and valproic acid（VPA） combination therapy after diagnosis of epilepsy and then transformed to lamotrigine monotherapy. Methods： Thirty-five epilepsy patients were recruited, with seizures completely controled after 6 months of treatment of low-dose LTG and VPA. The seizure frequency, adverse reactions and LTG blood drug concentration were observed and recorded. Results： Of 35 cases, 2 cases were lost during the 6 months of follow-up. Among them, 2 cases presented recurrent seizures in LTG monotherapy stage（6.1%）, 31 cases remained seizure-free（93.9%）. The LTG blood drug concentrations during transition stage were higher than those at combination therapy（P〈0.05）. No significant difference with LTG blood drug concentrations was observed in the patients at a week of removing VPA, six months of monotherapy and at combined treatment stage（P〉0.05）. The blood concentrations of 2 patients with recurrent seizure attacks at the LTG monotherapy stage showed no difference when compared with that in patients without attack（P〉0.05）. Conclusion： In combination with VPA, LTG blood drug concentration doubles and the efficacy improves when compared with LTG monotherapy. The LTG dosage should be doubled in order to maintain stable curative effect when patients are transformed into LTG monotherapy from low-dose LTG with VPA therapy.

关 键 词：拉莫三嗪 丙戊酸 癫痫 血药浓度 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学]