某三甲医院两种新型抗癫痫药物的血药浓度监测结果分析  

Analysis of blood concentration monitoring results of two new antiepileptic drugs in a 3A hospital

作　　者：黄莹莹[1] 许健[1] 孙一鸣 孔令提[1] 余美玲[1] Huang Yingying;Xu Jian;Sun Yiming;Kong Lingti;Yu Meiling(First affiliated hospital of Bengbu Medical College,Bengbu,Anhui,233000,China)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233000

出　　处：《齐齐哈尔医学院学报》2023年第9期867-870,共4页Journal of Qiqihar Medical University

基　　金：安徽省教育厅高校科学研究项目(KJ2020A0589、2022AH051483);蚌埠医学院科技计划项目(2020byzd089)。

摘　　要：目的分析某院开展的两种新型抗癫痫药物拉莫三嗪、奥卡西平的血药浓度监测结果,并对患者进行回访,结合血药浓度监测结果及回访结果综合评价两种新型抗癫痫药物的临床疗效,为指导新型抗癫痫药物的使用提供个体化给药建议。方法收集某院2020年1—12月使用新型抗癫痫药物拉莫三嗪、奥卡西平进行血药浓度监测患者的基本信息,对患者进行回访,分析血药浓度达标率与抗癫痫药物治疗有效率。结果共收集数据52例,排除空号,诊断和症状不符等情况,可用数据共42例。监测对象以中青年(19-60岁)为主,占71.43%,男性多于女性。奥卡西平监测结果在有效浓度的范围内的比例(89.66%)高于拉莫三嗪(15.38%)(P<0.05)。通过电话进行回访,联合用药患者共17例,其中联合拉莫三嗪和奥卡西平治疗有效率为33.33%;联合拉莫三嗪和丙戊酸钠治疗有效率为50%;联合丙戊酸钠和奥卡西平治疗有效率为40%;联合左乙拉西坦和奥卡西平治疗结果有效的例数是1例,有效率为100%。奥卡西平总有效率为51.72%,高于拉莫三嗪的30.77%(P<0.05)。结论新型抗癫痫血药浓度监测结果的总体达标率不够。对回访的结果进行分析,单药治疗有效率高于联合用药,奥拉西平总体有效率高于拉莫三嗪。抗癫痫药物血药浓度个体间差异大,应积极开展血药浓度监测,并根据监测结果及患者控制情况及时调整并优化给药方案,加强患者的用药教育,使患者更安全、合理的使用抗癫痫药物。Objective To analysethe blood drug concentration monitoring results of two new antiepileptic drug lamotrigine andoxcarbazepine in a hospital,and to provide telephone visit for patients,combined the blood drug concentration monitoring results and return results to comprehensively evaluate the clinical efficacy of the two new antiepileptic drugs,finally to provide individualized dosing recommendations for the use of new antiepileptic drugs.Methods The basic information was collected from patients administrated new antiepileptic drugs lamotrizine and oxcarbazepine and receiving blood drug concentration monitoringin a hospital during January and December 2020.The patients were given return review,and to analyze the compliance rate of blood drug concentration and the effective rate of antiepileptic drugs.Results A total of 52 cases were enrolled in the study,and the available data were 42 cases after excluding null numbers,diagnosis and symptom discrepancy,etc.The subjects were mainly young and middle-aged(aged 19-60),accounting for 71.43%,with more males than females.The proportion of oxcarbazepine in the range of effective concentration(89.66%)was higher than lamotrigine(15.38%).According to the return visit by phone,a total of 17 patients were treated with the combination of lamotrigine and oxcarbazepine,and the effective rate was 33.33%.The effective rate of lamotrigine and sodium valproatewas 50%.The effective rate of sodium valproate combined with oxcarbazepinewas 40%.1 case was treated with levetiracetam and oxcarbazepine,and the effective rate was 100%.The total effective rate of oxazepine was 51.72%,which was higher than 30.77%of Lamotrigine(P<0.05).Conclusions The overall compliance rate of blood concentration monitoring results of new antiepileptic drugs is not enough.The effective rate of mono-therapy was higher than combination therapy,and that of oxcarbazepine was higher than that of lamotrigine.Because the blood concentration of antiepileptic drugs varies greatly among individuals,so blood concentration

关 键 词：新型抗癫痫药 血药浓度监测 拉莫三嗪 奥卡西平 

分 类 号：R451[医药卫生—治疗学]