丙戊酸钠血药浓度影响因素及不良反应分析  

Analysis of the factors influencing sodium valproate blood concentration and adverse reactions

作　　者：张文滨 林燕 蔡优生 戴成家 ZHANG Wenbin;LIN Yan;CAI Yousheng;DAI Chengjia(Department of Pharmacy,Zhangzhou Affiliated Hospital of FuJian Medical University,Fujian Province,Zhangzhou 363000,China;不详)

机构地区：[1]福建医科大学附属漳州市医院药学部,福建省漳州市363000 [2]福建医科大学附属漳州市医院麻醉科,福建省漳州市363000 [3]福建医科大学附属漳州市医院神经内科,福建省漳州市363000

出　　处：《临床合理用药杂志》2024年第10期33-36,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 分析癫痫患者丙戊酸钠血药浓度的影响因素及血药浓度与不良反应的相关性,为临床合理用药提供参考。方法 回顾性分析2019年1月—2022年2月神经内科与神经外科使用丙戊酸钠的住院癫痫患者98例临床资料,收集患者相关信息与生化指标。应用SPSS 26.0软件,以多元线性回归分析法评价丙戊酸钠血药浓度与相关因素的关联性;以独立样本t检验分析肝功能、肾功能及碳青霉烯类抗生素对丙戊酸钠血药浓度的影响,并评价丙戊酸钠血药浓度对生化指标的影响。结果 癫痫患者血小板计数与丙戊酸钠血药浓度呈线性负相关(P<0.001);联用碳青霉烯类抗生素组丙戊酸钠血药浓度低于未联用碳青霉烯类抗生素组(t=-4.982,P<0.001);肝功能指标异常患者丙戊酸钠血药浓度低于肝功能指标正常患者(t=2.474,P=0.015);血药浓度≥100μg/ml患者血小板计数低于血药浓度<100μg/ml的患者(t=2.747,P=0.007)。结论 推荐使用丙戊酸钠患者常规监测血小板计数;癫痫患者丙戊酸钠血药浓度与肝功能异常有关,需关注该类患者肝功能指标及丙戊酸钠血药浓度的变化;碳青霉烯类抗生素能降低丙戊酸钠血药浓度,应避免联用。Objective To analyze the factors influencing sodium valproate blood concentration in patients with epilepsy,as well as the correlation between blood concentration and adverse reactions,aiming to provide reference for rational drug use in clinical practice.Methods A retrospective analysis of clinical data was conducted on 98 hospitalized epilepsy patients treated with sodium valproate from January 2019 to February 2022 in the departments of Neurology and Neurosurgery.Relevant patient information and biochemical indicators were collected.Using SPSS 26.0 software,multiple linear regression analysis was performed to evaluate the association between sodium valproate blood concentration and relevant factors.Independent sample t-tests were used to analyze the impact of patient′s liver function,renal function,and the use of carbapenem antibiotics on their sodium valproate blood concentration,as well as the influence of sodium valproate blood concentration on biochemical indicators.Results There was a linear negative correlation between platelet count and sodium valproate blood concentration in epilepsy patients(P<0.001).The group co-administered with carbapenem antibiotics had lower sodium valproate blood concentration compared to the non-carbapenem group(t=-4.982,P<0.001).Patients with abnormal liver function had lower sodium valproate blood concentration than those with normal liver function(t=2.474,P=0.015).Patients with blood concentrations≥100 μg/ml had lower platelet counts compared to patients with blood concentrations<100 μg/ml(t=2.747,P=0.007).Conclusion It is recommended to regularly monitor platelet count in patients using sodium valproate.The blood concentration of sodium valproate in epilepsy patients is associated with impaired liver function,and attention should be given to the liver function indicators and changes in sodium valproate blood concentration in such patients.The co-administration of carbapenem antibiotics can decrease the blood concentration of sodium valproate,and therefore,its concurre

关 键 词：癫痫 丙戊酸钠 血药浓度 血小板计数 肝功能 碳青霉烯类抗生素 

分 类 号：R969[医药卫生—药理学]