丙戊酸盐治疗成人双相情感障碍中的血药浓度与疗效分析  

Analysis of Blood Drug Concentration and Efficacy of Valproate Acid in the Treatment of Adult Bipolar Disorder

作　　者：罗骞 张乐群 廖丹 占海燕 LUO Qian;ZHANG Lequn;LIAO Dan;ZHAN Haiyan(Jiangxi Mental Health Center,Nanchang 360029,Jiangxi,China)

机构地区：[1]江西省精神病院,江西南昌360029

出　　处：《现代诊断与治疗》2024年第1期1-4,共4页Modern Diagnosis and Treatment

基　　金：江西省卫生健康委科技计划项目(项目编号202311304)。

摘　　要：目的探讨丙戊酸盐治疗成人双相情感障碍中的血药浓度与临床疗效。方法回顾性分析2021年1月至2023年4月我院收治的成人双相情感障碍60例患者的临床资料,所有患者均给予丙戊酸盐治疗,观察患者年龄、性别、体重、合并用药及给药剂量对丙戊酸盐血药浓度的影响,探讨丙戊酸盐血药浓度与临床疗效及不良反应的关系。结果患者年龄、体重、性别对丙戊酸血药浓度影响不明显;给药剂量在0.75~1 g/d时,平均血药浓度为(95.97±24.26)μg/mL,可达到最佳量效;合并用药数量增加,丙戊酸血药浓度降低;丙戊酸盐的不良反应发生率38.75%,血药浓度和不良反应发生率成正相关性,丙戊酸血浓度>120μg/mL时,不良反应显著增加;经spearman相关分析,浓度与疗效之间存在正相关关系,当丙戊酸钠浓度处于50~120μg/mL时可达到最佳疗效。结论丙戊酸盐治疗阈浓度在50~120μg/mL范围内安全有效。定期监测血药浓度可作为使用丙戊酸盐的成人双相情感障碍患者及时合理调整药物剂量的参考,为实施个体化给药方案提供依据。Objectives To evaluate the correlation between blood concentration,clinical efficacy,and adverse reactions of valproate in the treatment of adult bipolar disorder.Methods A retrospective study was conducted to analyze the clinical data of 60 adult bipolar disorder patients admitted to our hospital from January 2021 to April 2023.The effects of age,gender,weight,combined medication,and dosage on valproate blood concentration were observed,and the relationship between valproate blood concentration and clinical efficacy as well as adverse reactions was explored.Results The age,weight,and gender of patients have no significant impact on the blood concentration of valproic acid.When the dosage is 0.75~1 g/d,the average blood drug concentration is(95.97±24.26)μg/mL,which achieves the optimal dosage effect.The number of combined medications increases,and the blood concentration of valproic acid decreases.The incidence of adverse reactions of valproate is 38.75%,and the plasma concentration is positively correlated with the incidence of adverse reactions.When the blood concentration of valproic acid exceeds 120μg/mL,adverse reactions significantly increase.Spearman correlation analysis shows that there is a positive correlation between concentration and efficacy.The optimal therapeutic effect can be achieved when the concentration of sodium valproate is between 50 and 120μg/mL.Conclusions The blood concentration of valproate is safe and effective between 50 and 120 micrograms per milliliter.Regular monitoring of blood drug concentration can serve as a reference for timely and reasonable adjustment of drug dosage in adult patients with bipolar disorder who use valproate,providing a basis for the implementation of individualized drug administration plans.

关 键 词：丙戊酸盐 血药浓度 疗效 双相情感障碍 

分 类 号：R749.4[医药卫生—神经病学与精神病学]