桂北癫痫患儿左乙拉西坦稳态血药浓度影响因素及参考区间初探  

Preliminary study on influencing factors and reference interval of steady state plasma concentration in children with epilepsy in northern Guangxi

作　　者：经力 陈鑫 李江[1] 廖曾珍[1] 陈薇[1] JING Li;CHEN Xin;LI Jiang;LIAO Zengzhen;CHEN Wei(Pharmacy Department,the Affiliated Hospital of Guilin Medical University,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院药学部,广西桂林541001

出　　处：《临床医学研究与实践》2024年第34期6-9,共4页Clinical Research and Practice

基　　金：2022—2023年度广西壮族自治区卫生健康委药品临床综合评价课题(No.YPPJ009);中关村精准医学基金会医健公益行-医院管理专项课题(No.ZGC-YXKY-17)。

摘　　要：目的基于桂北癫痫患儿的临床数据,探讨影响左乙拉西坦(LEV)稳态血药浓度的因素,建立LEV稳态血药浓度参考区间,为该药的精准应用提供参考。方法收集2022年1月至2024年1月在桂林医学院附属医院就诊并至少进行一次血药浓度监测的109例癫痫患儿的177次血药浓度数据,将患儿依据年龄分为儿童组和青少年组,收集年龄、性别、给药日剂量等临床资料,分析影响LEV稳态血药浓度的因素,建立LEV稳态血药浓度参考区间。结果109例患儿共获取177次血药浓度,6次血药浓度明显偏低,考虑漏服药剔除,最终纳入106例患儿,171次血药浓度,平均LEV日给药剂量为(1.07±0.60)g,平均LEV稳态血药浓度为(10.01±6.32)μg/mL,参考区间为2.45~29.89μg/mL。多元线性回归分析结果显示,青少年组中,给药日剂量是儿童LEV血药浓度的影响因素(P<0.05)。结论相较国内其他地区,桂北癫痫患儿的LEV稳态血药浓度参考区间更低,给药日剂量是影响青少年LEV稳态血药浓度的因素。Objective To discuss the factors affecting the steady state plasma concentration of levetiracetam(LEV)based on the clinical data of children with epilepsy in northern Guangxi,to establish the reference interval of steady state plasma concentration of LEV,in order to provide references for the accurate application of the drug.Methods The 177 plasma concentration data of 109 children with epilepsy who were treated in the Affiliated Hospital of Guilin Medical University from January 2022 to January 2024 and were monitored plasma concentration at least once were collected.The children were divided into children group and adolescent group according to their age.The clinical data such as age,gender and daily dose were collected.The factors affecting the steady state plasma concentration of LEV were analyzed,and the reference interval of steady state plasma concentration of LEV was established.Results A total of 177 plasma concentrations were obtained from 109 children,and the plasma concentrations were significantly lower in 6 times.Considering the elimination of missed medication,106 children were finally included,with 171 plasma concentrations.The average daily dose of LEV was(1.07±0.60)g,and the average steady state plasma drug concentration of LEV was(10.01±6.32)μg/mL.The reference interval was 2.45-29.89μg/mL.The results of multivariate linear regression analysis showed that the daily dose of administration was the influencing factor of LEV plasma concentration in children in the adolescent group(P<0.05).Conclusion Compared with other regions in China,the reference interval of LEV steady state plasma concentration in children with epilepsy in northern Guangxi is lower.Daily dose is the factor affecting the steady state plasma concentration of LEV in adolescents.

关 键 词：左乙拉西坦 儿童 癫痫 血药浓度 

分 类 号：R742.1[医药卫生—神经病学与精神病学]