卡马西平对小儿癫痫患者血清钠的影响  

The Effect of Carbamazepine on Serum Sodium in Children with Epilepsy

作　　者：刘辰庚[1] 李秀玉[1] 程勇[1] 张蕴秀[1] 王红彦[1] 宿占军 张丽春[1] 王培昌[1] LIU Chen-geng;LI Xiu-yu;CHENG Yong;ZHANG Yun-xiu;WANG Hong-yan;SU Zhan-jun;ZHANG Li-chun;WANG Pei-chang(Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院检验科,北京100053

出　　处：《标记免疫分析与临床》2019年第3期364-367,共4页Labeled Immunoassays and Clinical Medicine

基　　金：北京市医院管理局"青苗"计划专项经费资助(编号:QML20150804)

摘　　要：目的探讨卡马西平、苯巴比妥、苯妥英钠和丙戊酸钠对癫痫患儿血清钠的影响。方法随机选取分别服用上述四种药物的癫痫患儿和成人癫痫患者各180例,并随机选取性别年龄匹配的儿童和成人健康对照,测定其血药谷浓度时的血清钠水平。结果服用卡马西平的患儿,其血药浓度谷水平时的血清钠浓度均显著低于小儿对照组、服用苯巴比妥的小儿癫痫组和服用卡马西平的成人癫痫组(P <0. 05)。服用苯妥英钠、苯巴比妥和丙戊酸钠的小儿癫痫患者,其血药浓度谷水平时的血清钠浓度与小儿对照组间无统计学差异(P>0.05)。服用卡马西平的患儿,其血药浓度谷水平时的血清钠阳性率(低于生物参考区间下限)均显著高于表面健康对照组和其他药物组和成年癫痫患者(P>0.05)。当血清钠离子浓度截断值为132.1 mmol/L时,对小儿癫痫的高血清卡马西平具有较好的诊断效率(灵敏度为83. 70%,特异性为87.65%)。结论本研究结果提示服用卡马西平的小儿癫痫患者,在用药期间,除应监控血药浓度外还应密切关注血清钠的变化趋势,以预防药物不良反应的发生。Objective To investigate the effects of carbamazepine,phenobarbital,phenytoin and sodium valproate on serum sodium in children with epilepsy.Methods 180 children with epilepsy and 180 adults with epilepsy who were treated with each of the above four drugs were randomly selected for the study.Age and sex matched health children and adults were randomly selected as the control.The serum sodium levels of all subjects were detected.Results Among case children taking carbamazepine,the serum sodium concentration at the plasma concentration level was significantly lower than those in health children,and case patients taking phenobarbital and carbamazepine in adults(P<0.05).Pediatric epilepsy patients taking phenytoin sodium,phenobarbital and sodium valproate had no significant differences in serum sodium concentration at the plasma concentration level,compared with that in pediatric control group(P>0.05).Children taking carbamazepine had a significantly higher serum sodium positive rate(lower than the lower limit of biological reference interval)for the level of plasma drug concentration(P>0.05),compared with those in the surface healthy control group and other drug groups and in adults with epilepsy.When serum sodium concentration was cut off at 132.1 mmol/L,the serum carbamazepine in children with epilepsy had a better diagnostic efficiency(sensitivity of 83.70%and specificity of 87.65%).Conclusion The results of this study suggest that for patients with epilepsy taking carbamazepine,in addition to monitoring blood concentration,physicians should pay close attention to the trend of serum sodium in order to prevent the occurrence of adverse drug reactions.

关 键 词：癫痫 卡马西平 血清钠 

分 类 号：R742.1[医药卫生—神经病学与精神病学]