Individualized Use Analysis of Valproate Based on Blood Concentration Monitoring in the Treatment of 384 Cases of Epilepsy
- VernacularTitle:基于血药浓度监测的丙戊酸钠治疗癫痫384例个体化用药分析
- Author:
Meng HE
1
;
Hailing DOU
;
Lijuan ZHOU
Author Information
1. 郑州大学附属郑州中心医院转化医学中心 郑州450007
- Keywords:
Valproate;
Epilepsy;
Blood concentration monitoring;
Clinical effect;
Safety
- From:
China Pharmacist
2018;21(5):864-866
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the guiding role of blood concentration monitoring (TDM) for valproate (VPA) in the treatment of epilepsy,and provide reference for the clinical rational use. Methods:Totally 384 epilepsy patients treated with VPA alone were collected between August 2016 and November 2017 in our hospital. The serum concentrations of VPA were determined by HPLC. The relationship was analyzed between TDM and the efficacy and safety. The correlation between TDM and factors(age, dose,sex and dosage form)was assessed using binary logistic regression. Results:Among the 384 patients,272 (70.83%) ones were with an effective range of blood (50-100 μg·ml-1). The clinical efficacy within the range of effective blood concentration (50-100 μg·ml-1) and that with the plasma concentration above 100 μg·ml-1were both significantly higher than that with the plasma concentration below 50 μg·ml-1(P < 0.01). The incidence of adverse reactions with the range above 100 μg·ml-1was significantly higher than that with the range below 50 μg·ml-1and within the range of 50-100 μg·ml-1. Logistic regression analysis showed that dose and age had significant effect on the blood concentration(P < 0.05). Conclusion:The individual difference of VPA is obvious,therefore,VPA should be used in clinic based on TDM to improve the clinical effect and reduce the adverse reactions.
