北京某三甲医院6537例7种新型抗癫痫药物血药浓度监测与分析  

Monitoring and Analysis of Blood Concentrations of Seven New Antiepileptic Drugs on 6537 Cases in A Grade-A Tertiary Hospital in Beijing

作　　者：李欣恬 张冬婕 杨莉[2] 赵志刚[2] 梅升辉[2] 霍记平[2] LI Xintian;ZHANG Dongjie;YANG Li;ZHAO Zhigang;MEI Shenghui;HUO Jiping(College of Pharmacy,Capital Medical University,the Fifth Clinical School of Medicine,Capital Medical University,Beijing 100070,China;Department of Pharmacy,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学药学院,首都医科大学第五临床医学院,北京100070 [2]首都医科大学附属北京天坛医院药学部,北京100070

出　　处：《医药导报》2024年第12期2026-2032,共7页Herald of Medicine

基　　金：临床重点药品的使用监测和评价研究专项(2023)(Y2023FH-YWPJ03-201);国家重点研发计划“主动健康和老龄化科技应对”“基于肝药酶基因与药物代谢模型的老年人个体化用药智能决策系统的建立”项目(2020YFC2008306)

摘　　要：目的对7种新型癫痫药物左乙拉西坦(LEV)、奥卡西平(OXC)、拉莫三嗪(LTG)、托吡酯(TPM)、拉考沙胺(LCM)、唑尼沙胺(ZNS)、吡仑帕奈(PER)的血药浓度监测结果进行分析,为临床合理用药提供依据。方法回顾性分析北京某三甲医院2021年11月—2023年3月7种新型抗癫痫药物的血药浓度监测结果,共收集有效浓度数据6537例次。根据患者年龄、性别、合并用药情况进行分组,分析并比较各组间的血药物浓度水平及达标率。结果患者男/女比例为1.35∶1。OXC、LEV、LCM、TPM的血药浓度分布在性别上表现出显著差异(P<0.05)。LEV血药浓度在儿童组与老年组、青中年组与老年组间比较,差异有统计学意义(P<0.05);OXC、ZNS、TPM的血药浓度分别在儿童组与青中年组、青中年组与老年组、儿童组与青中年组间比较,差异有统计学意义(P<0.05)。血药浓度总达标率最高和最低的药物分别为OXC、LCM;不同年龄段间达标率进行多组间比较,儿童组OXC和TPM浓度达标率显著高于青中年组(P<0.05),老年组LEV浓度达标率显著高于儿童组和青中年组(P<0.05)。合并用药共计2133例次,添加治疗时使用频次高且疗效好、相互作用弱的药物为LEV、OXC和LTG。结论新型抗癫痫药物在治疗中展现出良好的前景,通过治疗药物监测能够进一步提高临床个体化治疗效果。Objective To analyze the blood concentration monitoring results of 7 new antiepileptic drugs levetiracetam(LEV),oxcarbazepine(OXC),lamotrigine(LTG),topiramate(TPM),lacosamide(LCM),zonisamide(ZNS)and perampanel(PER)and provide a basis for clinical rational drug use.Methods Aretrospective analysis was conducted on the blood concentration monitoring results of 7 new antiepileptic drugs in a grade-A tertiary hospital in Beijing from November 2021 to March 2023,with a total of 6537 valid concentration data collected.The patients were grouped according to age,gender and concomitant medication,and the blood drug concentration levels and compliance rates among the groups were analyzed and compared.Results The male to female patient ratio was 1.35∶1.There were statistically significant differences in the blood concentration distribution of OXC,LEV,LCM and TPM between genders(P<0.05).The blood concentration of LEV showed statistically significant differences between the pediatric group and the elderly group,as well as between the young adult group and the elderly group(P<0.05).The blood concentrations of OXC,ZNS and TPM showed statistically significant differences between the pediatric group and the young and middle-aged group,between the young and middle-aged group and the elderly group,and between the pediatric group and the young and middle-aged group,respectively(P<0.05).The highest and lowest overall compliance rates of blood concentration were observed for OXC and LCM,respectively.The compliance rates of OXC and TPM in the pediatric group were significantly higher than those in the young-middle-aged group,with statistically significant differences(P<0.05),while the compliance rate of LEV in the elderly group was significantly higher than that in the pediatric group and the young-middle-aged group,with a statistically significant difference(P<0.05).There were a total of 2133 cases with combined drug use.LEV,OXC and LTG are frequently used and have good efficacy and weak interactions when added to treatment.Conclusio

关 键 词：新型抗癫痫药物 治疗药物监测 血药浓度 合并用药 癫痫 

分 类 号：R971.6[医药卫生—药品]