左乙拉西坦与卡马西平联合治疗对癫痫患者骨代谢、血药浓度的影响以及成本效价分析  

Analysis on the Effect of Levetiracetam Combined with Carbamazepine on Bone Metabolism, Blood Concentration and Cost-titer in Patients with Epilepsy

作　　者：闻世祺 张可帅 赵国庆 姜晨辉[3] WEN Shiqi;ZHANG Keshuai;ZHAO Guoqing;JIANG Chenhui(Haicheng Chinese Medicine Hospital,Haicheng 114200,China)

机构地区：[1]辽宁省海城市中医院,辽宁海城114200 [2]北部战区空军医院 [3]沈阳市红十字医院

出　　处：《中国医学创新》2019年第32期43-47,共5页Medical Innovation of China

基　　金：辽宁省科学技术计划项目（2013225049）

摘　　要：目的:探讨左乙拉西坦和卡马西平分别应用于癫痫的治疗,对患者骨代谢影响,并对其药物浓度、成本效价进行分析。方法:选择2014年2月-2016年9月医院收治的癫痫患者87例,按照不同癫痫治疗方案分成左乙拉西坦组(43例)和卡马西平组(44例)。于治疗前和治疗6个月后,比较两组骨代谢的变化,并对血药浓度、不良反应、成本效价进行分析。结果:治疗6个月后,两组P、Ca、ALP、BAP表达水平均显著低于治疗前,差异均有统计学意义(P<0.05);但两组上述指标比较,差异均无统计学意义(P>0.05)。两组用药2周后的血药浓度比较,差异均无统计学意义(P>0.05)。治疗6个月后,卡马西平组总成本、药费、CER均低于左乙拉西坦组,差异均有统计学意义(P<0.05)。治疗6个月期间,左乙拉西坦组不良反应发生率为13.95%,低于卡马西平组的38.64%,差异有统计学意义(P<0.05)。结论:在癫痫的临床治疗中,使用左乙拉西坦和使用卡马西平均具有良好的促进骨代谢的作用,两者血药浓度也较为相似,左乙拉西坦不良反应发生率显著低于卡马西平,但卡马西平的成本效价比明显优于左乙拉西坦。Objective: To investigate the effect of Levetiracetam and Carbamazepine on bone metabolism in patients with epilepsy, and to analyze the drug concentration and cost-effect. Method: From February 2014 to September 2016, 87 epilepsy patients who were admitted to the hospital were selected, they were divided into the Levetiracetam group(43 cases) and Carbamazepine group(44 cases) according to different epilepsy treatment schemes. Changes of bone metabolism were compared before and after 6 months of treatment in the two groups, and the blood drug concentration, adverse reactions and cost-effect were analyzed. Result: After 6 months of treatment, the expression levels of P, Ca, ALP and BAP in the two groups were significantly lower than those of before treatment, with statistically significant differences(P<0.05);however, there were no significant differences in the aboue indicators between the two groups(P>0.05). There was no statistically significant difference in blood concentration between the two groups after 2 weeks of administration(P>0.05). After 6 months of treatment, the total cost, drug cost and CER of Carbamazepine group were lower than those of Levetiracetan group, with statistically significant differences(P<0.05). During the 6 months of treatment, the incidence of adverse reactions in the Levetiracetam group was 13.95%, lower than 38.64% in the Carbamazepine group, the difference was statistically significant(P<0.05). Conclusion: In the clinical treatment of epilepsy, Levethracetam and Carbamazepine both have a good effect of promoting bone metabolism, and the blood concentration of them is also relatively similar, the incidence of adverse reactions of Levethracetam is significantly lower than that of Carbamazepine, but the cost-effect ratio of Carbamazepine is significantly better than that of Levethracetam.

关 键 词：左乙拉西坦 卡马西平 癫痫 血药浓度 骨代谢 成本效价 

分 类 号：R74[医药卫生—神经病学与精神病学]