低血浆白蛋白对丙戊酸钠血药浓度的影响  

Effect of low plasma albumin on the plasma concentration of sodium valproate

作　　者：董露露 蒋艳[1] 邹素兰[1] 胡楠[1] 杨旭萍 凌静[1] DONG Lu-lu;JIANG Yan;ZOU Su-lan;HU Nan;YANG Xu-ping;LING Jing(Department of Pharmacy,the First People's Hospital of Changzhou,Changzhou 213000,China)

机构地区：[1]常州市第一人民医院药学部,江苏常州213000

出　　处：《中国药物应用与监测》2023年第3期159-162,共4页Chinese Journal of Drug Application and Monitoring

基　　金：常州市第十七批科技计划(应用基础研究指导性)项目(CJ20209023);常州市卫生健康青苗人才培养工程基金资助项目(CZQM2020019);常州市科技基础设施建设计划-常州市临床药学重点实验室项目(CM20223005)。

摘　　要：目的:研究低血浆白蛋白(Alb)对丙戊酸钠(VPA)浓度的影响。方法:选取常州市第一人民医院2018年1月–2022年3月使用VPA并进行血药浓度监测的564例患者,血浆Alb<35 g·L^(-1)为试验组,≥35 g·L^(-1)为对照组,收集患者一般临床资料、用药情况及VPA血药浓度监测结果等信息,比较VPA血药浓度、剂量校正浓度及肝功能异常发生率的差异,并分析Alb含量对低血浆Alb患者VPA浓度的影响。结果:试验组与对照组患者VPA平均血药浓度为(77.40±28.47)和(67.14±29.33)μg·mL^(-1),平均剂量校正浓度为(7.92±2.69)·10^(-2)和(6.99±2.43)·10-2μg·mL^(-1)·mg^(-1),肝功能异常发生率为17.05%和10.46%,在低血浆Alb患者中,Alb重度降低组和中度降低组VPA浓度显著高于轻度降低组,以上差异均具有统计学意义(P<0.05)。结论:低血浆Alb患者VPA浓度及肝功能异常发生率显著升高,针对此类患者可考虑适当降低VPA剂量,增加血药浓度监测频率并制定个体化用药方案,保证用药合理有效。Objective:To investigate the effect of low plasma albumin(Alb)on blood concentration of sodium valproate(VPA).Methods:A total of 564 epilepsy patients using VPA with therapeutic drug monitoring(TDM)during hospitalization in the First People's Hospital of Changzhou from January 2018 to March 2022 were selected and divided into the experiment group(Alb below 35 g·L^(-1))and the control group(Alb above or equal to 35 g·L^(-1)).And the differences in blood concentration and dose-corrected concentration of VPA,and the incidence of abnormal liver function were compared between the two groups.Results:In the experiment group and the control group,the average plasma concentration of VPA was(77.40±28.47)and(67.14±29.33)μg·mL^(-1)respectively,the average dose-corrected concentration of VPA was(7.92±2.69)·10-2μg·mL^(-1)·mg^(-1)and(6.99±2.43)·10^(-2)μg·mL^(-1)·mg^(-1)respectively,and the incidence of abnormal liver function was 17.05%and 10.46%respectively.In patients with low plasma Alb,VPA concentration in patient with Alb severely and moderately decreased were significantly higher than that in patient with Alb mildly decreased.All the above differences were statistically significant(P<0.05).Conclusion:VPA concentration and the incidence of abnormal liver function in patients with low plasma Alb were significantly increased.It is suggested to appropriately decrease the dose of VPA,increase the frequency of TDM,and make an individualized drug regimen in order to ensure the reasonable and effective drug use in patients with low plasma Alb.

关 键 词：丙戊酸钠 血药浓度 白蛋白 肝功能异常 

分 类 号：R917[医药卫生—药物分析学] R971.6[医药卫生—药学]