丙戊酸对癫痫患者拉莫三嗪血药浓度的影响  

Influence of valproic acid on serum concentration of lamotrigine in epileptic patients

作　　者：杨帆[1,2] 陈亚南[2] 张媞[2] 肇丽梅[1,2] 

机构地区：[1]沈阳药科大学生命科学与生物制药学院,沈阳110016 [2]中国医科大学附属盛京医院药学部,沈阳110004

出　　处：《中国临床药理学杂志》2016年第10期883-886,共4页The Chinese Journal of Clinical Pharmacology

基　　金：辽宁省自然科学基金资助项目(2013021079)

摘　　要：目的考察丙戊酸(VPA)联合拉莫三嗪(LTG)治疗时,癫痫患者体内丙戊酸对拉莫三嗪药代动力学的影响,以及联合用药的有效性及安全性。方法共收集符合入选标准的癫痫患者病例294例,拉莫三嗪+丙戊酸合用组(A)72例,拉莫三嗪单用组(B)92例,丙戊酸单用组(C)130例,分析各组之间血药浓度、临床疗效、不良反应的差异。结果 A组的拉莫三嗪血药浓度与标准化血药浓度(CDR_(拉莫三嗪))分别是B组2.23、1.93倍(P<0.01,P<0.01),A组与C组的丙戊酸浓度和CDR_(丙戊酸)相比,差异无统计学意义(P>0.05,P>0.05)。A组中不同丙戊酸浓度对拉莫三嗪浓度及CDR_(拉莫三嗪)无影响(P>0.05)。A组的控制率显著高于B组和C组(P<0.05,P<0.05)。3组不良反应发生率差异均无统计学意义(P>0.05)。结论拉莫三嗪与丙戊酸联合治疗时,临床疗效显著,但丙戊酸可增加拉莫三嗪的血药浓度,在合用时需调整拉莫三嗪剂量,以减少不良反应的发生。Objective To investigate the interactions between lamotrigine（ LTG） and valproic acid（ VPA） in epileptic patients,as well as the effectiveness and safety of combination therapy.Methods A total of 294 cases were divided into 3 groups,LTG in combination with VPA group（ group A,72 cases）,LTG group（ group B,92 cases）,VPA group（ group C,130 cases）,then analyze the blood concentration,curative effect and side-effect among three groups.Results The serum concentration of LTG and standardized concentration in group A are higher than those in group B with significant differences（ P〈0.01,P〈0.01）.Unfortunately,there was no significant difference between group C and group A in the serum concentration of VPA and standardized concentration（ P〉0.05,P〉0.05）.The results showed the efficacy rate of group A was significantly higher than that of group B and C（ P〈0.05,P〈0.05）.The incidence of adverse reactions had no statistically difference among the three groups（ P〉0.05）.Conclusion The efficacy and safety of LTG in combination with VPA treatment are better than those of VPA monotherapy or LTG monotherapy in epileptic patients.When co-administrated with VPA,the dose of lamotrigine should be reduced in order to avoid the adverse reactions according to the concentration of LTG.

关 键 词：拉莫三嗪 丙戊酸 相互作用 治疗药物监测 联合用药 

分 类 号：R971.6[医药卫生—药品]