某儿童医院31744例次丙戊酸治疗药物监测结果的回顾性分析  

Retrospective Analysis on 31,744 Cases of Therapeutic Drug Monitoring of Valproate in a Children’s Hospital

作　　者：邓后亮 谢萍 莫小兰 Deng Houliang;Xie Ping;Mo Xiaolan(Guangzhou Women and Children’s Medical Center,Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心,广州510120

出　　处：《儿科药学杂志》2025年第4期14-17,共4页Journal of Pediatric Pharmacy

摘　　要：目的:分析儿童癫痫患者丙戊酸治疗药物监测结果,为临床个体化用药提供参考。方法:收集我院2012-2023年所有接受丙戊酸治疗药物监测的门诊及住院儿童癫痫患者的性别、年龄、血药浓度数据,并对结果进行统计分析。结果:2012-2023年接受治疗药物监测患儿共9209例,累计监测31744例次,11477例次(36.2%)丙戊酸血药浓度<50 mg/L,50~100 mg/L的有18186例次(57.3%),>100 mg/L的有2081例(6.6%)。不同年龄段、性别、就诊类型患儿的丙戊酸血药浓度分布比较差异均有统计学意义(P<0.05)。门诊患者丙戊酸血药浓度高于住院患儿(P<0.01);不同年龄段患者丙戊酸血药浓度比较差异有统计学意义(P<0.01);男性和女性患儿丙戊酸血药浓度比较差异无统计学意义(P>0.05)。多重线性回归分析显示性别和年龄对丙戊酸血药浓度的影响差异有统计学意义(P<0.01)。结论:丙戊酸血药浓度个体差异较大,可结合患儿性别、年龄进行个体化给药以提高丙戊酸血药浓度在治疗参考范围的比例。Objective:To analyze the therapeutic drug monitoring(TDM)results of valproate in children with epilepsy,and provide reference for individualized medication therapy.Methods:The gender,age,and blood concentration data of all outpatient and inpatient children with epilepsy who underwent TDM of valproate in our hospital from 2012 to 2023 were collected and statistically analyzed.Results:A total of 9,209 pediatric epilepsy patients received TDM from 2012 to 2023 were monitored 31,744 times.The blood concentration of valproate was<50 mg/L in 11,477 cases(36.2%),50 to 100 mg/L in 18,186 cases(57.3%),and>100 mg/L in 2,081 cases(6.6%).There were statistically significant differences in the distribution of valproate concentration among patients of different age groups,genders,and visit types(P<0.05).The valproate concentration in outpatients was higher than that in inpatients(P<0.01).There were significantly differences in valproate concentration among different age groups(P<0.01).There was no significantly difference in valproate concentration between male and female patients(P>0.05).Multiple linear regression analysis showed that gender and age had a statistically significant impact on valproate concentration(P<0.01).Conclusion:The blood concentration of valproate varies greatly among pediatric individuals.Individualized administration can be considered with patients’gender and age to increase the proportion of valproate concentration within the treatment reference range.

关 键 词：丙戊酸 治疗药物监测 血药浓度 儿童 个体化用药 

分 类 号：R969.3[医药卫生—药理学]