妊娠合并癫痫患者孕期抗癫痫药物血液浓度以及服用种类和数量对妊娠结局的影响  

Effects of Type,Quantity and Blood Concentration of Antiepileptic Drugs Taken During Pregnancy on Pregnancy Outcomes in Pregnant Women with Epilepsy

作　　者：李巧艳[1] 马爱玲[1] 王漪檬[1] 杨丹 陈晓萌[1] 陈辞[1] 赵宁民[1] LI Qiao-yan;MA Ai-ling;WANG Yi-meng;YANG Dan;CHEN Xiao-meng;CHEN Ci;ZHAO Ning-min(Department of Pharmacy,Henan Provincial People's Hospital,Henan Zhengzhou 450003,China)

机构地区：[1]河南省人民医院药学部,河南郑州450003

出　　处：《中国药物评价》2024年第1期78-80,共3页Chinese Journal of Drug Evaluation

摘　　要：目的:回顾性分析妊娠合并癫痫患者孕期抗癫痫药物服用情况以及血液药物浓度对妊娠结局的影响,为癫痫女性备孕以及孕期抗癫痫药物安全、有效服用提供科学依据。方法:收集2017年至2022年我院就诊癫痫女性备孕期以及孕期抗癫痫药物服用情况和血药浓度数据,统计分析妊娠结局。分析抗癫痫药物妊娠期应用和药物浓度对孕妇癫痫发作的控制情况和对孕妇以及胎儿的影响。结果:相较于足月正常妊娠的癫痫患者,出现不良妊娠结局的患者孕期抗癫痫药物血液浓度偏低比率更高(65.2%vs 9.1%,P=0.002)。服用传统抗癫痫药物相较于新型抗癫痫药物出现不良妊娠结局的比率更高(92.3%vs 19%,P=0.000)。多药联合抗癫痫出现不良妊娠结局的概率虽略高于单药治疗(50%vs 44.4%),但差异不具统计学意义(P=0.746)。结论:癫痫合并妊娠的患者妊娠期癫痫控制情况是影响妊娠结局的重要因素,患者应根据治疗药物监测结果科学服用抗癫痫药物,过度担忧抗癫痫药物的不良反应导致服药依从性降低进而引起体内药物浓度偏低,会使不良妊娠结局风险增加。育龄期癫痫患者应科学备孕,在妊娠前及时科学调整抗癫痫药物的种类和数量以降低不良妊娠风险。Objective:To retrospectively analyze the use of antiepileptic drugs during pregnancy and the effect of blood drug concentra-tion on pregnancy outcomes in pregnant women with epilepsy,in order to provide scientific basis for pregnant women with epilepsy to pre-pare for pregnancy and for the safe and effective use of antiepileptic drugs during pregnancy.Methods:The data of antiepileptic drug use and blood drug concentration of women with epilepsy in our hospital during pregnancy preparation and pregnancy from 2017 to 2022 were collected,as well as the pregnancy outcomes.Analyze the effects of the use and concentration of antiepileptic drugs on the control of epi-leptic status of pregnant women and on pregnant women and fetuses.Results:Compared with epilepsy patients with normal term pregnan-cy,the blood concentration of antiepileptic drugs in patients with adverse pregnancy outcomes was generally lower during pregnancy(65.2%vs 9.1%,P=0.002).Compared with new antiepileptic drugs,taking traditional drugs is more likely to cause adverse pregnan-cy outcomes(92.3%vs 19%,P=0.000).The probability of adverse pregnancy outcome of multi-drug combined antiepileptic therapy was also higher than that of single-drug therapy(50%vs 44.4%),but the difference was not statistically significant(P=0.746).Conclusion:Epilepsy control during pregnancy in patients with epilepsy and pregnancy is an important factor that affects pregnancy out-comes.Patients should take anti-epileptic drugs scientifically based on the results of therapeutic drug monitoring.Overworrying about the adverse reactions of anti-epileptic drugs can lead to reduced drug compliance and lower drug concentration in the body,which can increase the risk of adverse pregnancy outcomes.Patients with epilepsy and pregnancy should seek medical advice before pregnancy.Timely and scientific adjustment of the type and quantity of anti-epileptic drugs can reduce the risk of adverse pregnancy.

关 键 词：癫痫合并妊娠 治疗药物监测 妊娠结局 

分 类 号：R971.6[医药卫生—药品]