HLA-B^*15:02基因阳性癫痫患者药物治疗及监护案例分析  

A case report of drug treatment in patient with epilepsy carried HLA-B^*15:02

作　　者：董雪[1] DONG Xue(Zhuhai Maternity and Child Health Hospital,Zhuhai,Guangdong 519000,China)

机构地区：[1]珠海市妇幼保健院,广东珠海519000

出　　处：《中国处方药》2020年第4期17-19,共3页Journal of China Prescription Drug

摘　　要：目的为药物基因阳性癫痫患者提供合理的抗癫痫药物治疗和监护方案。方法临床药师建立实践模式,用于1例HLA-B*15:02基因阳性癫痫患者,通过文献数据评价HLA-B*15:02基因与拉莫三嗪所致严重皮肤不良反应的相关程度,结合患儿个体情况评估用药风险,辅助医师合理选择抗癫痫药物并实施重点监护。结果 HLA-B*15:02基因与拉莫三嗪所致严重皮肤不良反应具有一定相关性,患儿规避使用拉莫三嗪,后经丙戊酸钠联合托吡酯治疗,癫痫发作控制后出院。结论实践模式在病例中具有可操作性,可推广用于更多的癫痫患者用药分析。Objective To provide rational antiepileptic drug therapy for epilepsy patients with drug-related genes. Methods A pattern was established by pharmacists and practiced on an epilepsy patient carried HLA-B*15:02. The correlation on HLA-B*15:02 and lamotrigine induced severe cutaneous adverse drug reactions was evaluated based on literature data. Then estimated drug risk combined with individual situation of the patient to optimize drug treatment and reinforce pharmaceutical care. Results The data showed positive association of HLA-B*15:02 with lamotrigine induced severe cutaneous adverse drug reactions. Avoiding to choose lamotrigine was recommended by clinical pharmacists. The seizure was controlled after treatment with valproate and topiramate. Conclusion The practice pattern was operable in this case, and should be extended to more drug analysis for patient with epilepsy.

关 键 词：药物基因组学 抗癫痫药物 特异质反应 

分 类 号：R969[医药卫生—药理学]