摘要
目的:探讨丙戊酸钠治疗小儿癫痫的效果及影响血药浓度的因素。方法:回顾性分析2014年7月至2017年7月三家三甲医院儿科使用丙戊酸钠进行治疗的癫痫患儿312例。所有患儿均进行CYP2C19基因多态性检测,确定患儿的CYP2C19的基因类型。口服丙戊酸钠治疗10 d,待血药浓度稳定后进行血药浓度检测。结果:患儿治疗后显效125例(40. 06%),有效138例(44. 23%),总有效率为84. 29%;平均血药浓度(44. 59±27. 60)μg/mL,6～11岁患儿平均血药浓度[(84. 33±22. 56)μg/mL]高于其他年龄段患儿。基因型EM的患儿144例(46. 15%),基因型IM的患儿70例(22. 43%),基因型PM(弱代谢)患儿98例(31. 41%)。<3岁EM患儿血药浓度最低[(26. 31±13. 22)μg/mL],6～11岁PM患儿的血药浓度最高[(96. 31±34. 25)μg/mL]。结论:小儿癫痫使用丙戊酸钠治疗有效率84. 29%,可以根据患儿的年龄和基因类型,合理调整治疗方案,达到最佳的治疗效果。
Objective:To investigate the effects of sodium valproate on children with epilepsy and influencing factors of blood concentration.Methods:Retrospective analysis was conducted on data of 312 epilepsy children with application of sodium valproate admitted into pediatrics of three grade Ⅲ level A hospitals from Jul.2014 to Jul.2017.All children were tested for CYP2C19 gene polymorphism to determine the gene type of CYP2C19.Oral sodium valproate treatment was performed for 10 d,and the blood drug concentration was determined after it was stabilized.Results:After treatment,125cases (40.06%)were significantly effective,138 cases (44.23%)were effective,and the total effective rate was 84.29%.The average blood concentration was 44.59±27.60μg/mL. The average blood concentration of the 6 to 11years old children 84.33±22.56μg,/mL was higher than that of the other age groups. There were 144 cases (46.15%)with genotype EM,70cases (22.43%)with genotype IM,and 98 cases (31.41%)with genotype PM (hypometabolism).The lowest blood concentration was found in EM children aged <3 years 26.31±13.22μg/mL and the highest concentration was found in PM children aged 6 to 11 years 96.31±34.25μg/mL Conclusion:The effective rate of sodium valproate for the treatment of epilepsy in children was 84.29%,and the treatment scheme can be adjusted reasonably according to the age and genotype of the children to achieve the best therapeutic effect.
作者
曹建伟
肖慧媚
曾向东
刘美玲
李莹莹
Cao Jianwei;Xiao Huimei;Zeng Xiangdong;Liu Meiling;Li Yingying(Zhongshan People's Hospital, Guangdong Zhongshan 528400, China;Guangdong Maternal and Child Health Hospital, Guangdong Guangzhou 510010, China;Chengdu Women and Children's Central Hospital, Sichuan Chengdu 610031, China)
出处
《儿科药学杂志》
CAS
2019年第1期20-23,共4页
Journal of Pediatric Pharmacy
关键词
小儿
癫痫
丙戊酸钠
血药浓度
基因多态性
children
epilepsy
sodium valproate
blood concentration
gene polymorphism
