摘要
目的:探讨儿童癫痫患者奥卡西平活性代谢物(MHD)血药浓度的影响因素。方法:收集2015年9月～2017年6月首都医科大学宣武医院进行MHD血药浓度监测的儿童癫痫患者1 220例,采用HPLC法测定MHD血浓度,选取单药或仅合并一种抗癫痫药的患者(共952例),利用偏相关分析和协方差分析方法分析患儿年龄、性别、剂量、联合用药等因素对MHD血药浓度的影响。结果:不同性别患儿的MHD血药浓度无显著差异。年龄和奥卡西平剂量与MHD血药浓度有正相关性,偏相关系数分别为r=0. 25(P <0. 001)和r=0. 51(P <0. 001);联合使用苯巴比妥使MHD血药浓度降低(P <0. 05),联合使用拉莫三嗪使MHD血药浓度升高(P <0. 05)。合并用苯巴比妥呈负相关(P <0. 05);而合并使用左乙拉西坦、卡马西平、丙戊酸钠和托吡酯对患儿MHD血药浓度无显著影响(P> 0. 05)。结论:儿童癫痫患者MHD血药浓度受年龄、单位剂量、联合用药等因素影响。在制订给药方案时,应考虑患儿年龄、剂量及合并用药,以提高治疗的有效性和安全性。
Objective :To explore the influencing factors in the plasma concentration of oxcarbazepine active metabolite (MHD)in children with epilepsy.Methods:A total of 1220 children with epilepsy were enrolled in Xuanwu hospital of capital medical university from September 2015 to June 2017.The plasma concentration of MHD was determined by HPLC.Totally 952 cases treated with oxcarbazepine alone or with one more other antiepileptic drug were analyzed.The effects of age,sex,dose and concomitant antiepileptic drugs (AEDs)on MHD plasma concentration were analyzed by using logistic regression.Results:MHD plasma concentration had no significant difference between boys and girls.MHD plasma concentration positively correlated with age and the dose of oxcarbazepine with the partial correlation coefficient of 0.25(P <0.001)and 0.51(P <0.001),respectively.It was positively correlated with lamotrigine (P <0.05),while negatively correlated with phenobarbital (P <0.05).The combination with carbamazepine,levetiracetam, valproic acid and topiramate had no significant effects on the plasma concentration of MHD in children (P >0.05).Conclusion : MHD blood concentration in children with epilepsy is affected by factors such as age,dose and concomitant antiepileptic drugs (AEDs).The concomitant with phenobarbital influences the plasma concentration of MHD evidently.It is necessary to regulate the regimen with different situations.In the regimen development of children,age,dose and combined medications should be considered to improve the effectiveness and safety of treatment.
作者
王彦改
刘博
杨昆
沈芊
王雪梅
苏甦
闫素英
Wang Yangai;Liu Bo;Yang Kun;Shen Qian;Wang Xuemei;Su Su;Yan Suying(Department of Pharmacy,Xuanwu Hospital of Capital Medical University,Beijing 100053,China;Department of Pharmacy,Beijing Xiaotangshan Hospital;Center for Evidence-based Medicine,Xuanwu Hospital,Capital Medical University)
出处
《中国药师》
CAS
2018年第12期2180-2182,共3页
China Pharmacist
关键词
奥卡西平活性代谢物
儿童癫痫患者
血药浓度监测
影响因素
Oxcarbazepine active metabolite
Epilepsy children
Plasma concentration monitoring
Influencing factors
