摘要
目的研究丙戊酸钠血药浓度的监测,为临床合理用药提供参考。方法收集福州总医院2015年4月—2016年3月期间进行丙戊酸钠血药浓度分析的129例癫痫患者的分析报告,临床药师结合患者病情根据不同浓度范围进行分析,并对其分析报告进行统计分析。结果根据不同浓度范围,临床药师提出4种不同的分析意见,其中建议调整丙戊酸钠给药剂量的32例,建议维持丙戊酸钠给药剂量的69例,建议增、减其他抗癫痫药物的20例,建议调整其他非抗癫痫的用药8例。对于浓度<50μg·ml^(-1)的分析报告,分析建议中调整丙戊酸钠给药剂量的建议接受度最高,差异有统计学意义(P<0.05);对于浓度为50~100μg·ml^(-1)的分析报告,分析建议中维持丙戊酸钠给药剂量的建议接受度最高,差异有统计学意义(P<0.05);而对于浓度>100μg·ml^(-1)的分析报告,临床药师和临床医师均认为应调整丙戊酸钠的给药剂量或通过调整抗癫痫治疗方案,避免不良反应的发生。结论通过个体化的血药浓度分析,临床药师加强了与临床医师的合作,为提高临床疗效,减少不良反应的发生提供了有利的帮助。
Objective Monitoring the blood concentrations of valproate in order to provide reference for clinical rational drug use.Methods The analytic reports on 129 patients with epilepsy whose blood drug concentration of valproate had been analyzed between April 2015 and March 2016 at a hospital were collect- ed and analyzed statistically by clinical pharmacists according to difference in concentrations. Results Ac- cording to different concentrations,clinical pharmacists offered four different recommendations.It was rec- ommended that the dose of valproate be adjusted in 32 eases,maintained in 69 cases,increased or reduced in 20 eases,and suspended in 8 cases.The recommendation to adjust the dose of valproate was the most ac- ceptable for concentrations 〈50μg·ml^-1 in the analytic reports.The difference was statistically significant （ P ~0.05）.For analytic reports with concentrations ranging from 50μg·ml^-1 to 100 μg·ml^-1 ,the recom- mendation to maintain the dose of valproate seemed the most acceptable,and the difference was of statisti- cal significance（ P 〈0.05）.For analytic reports with concentrations above 100 μg·ml^-1 ,it was recommen- ded that the dose of valproate be changed or the anti--epileptic therapy be changed to prevent any adverse reactions.Conclusion By means of individunlized analysis of blood drug concentrations, clinical pharmacists can enhance their collaboration with clinical physicians so as to improve the clinical efficacy and reduce the incidence of adverse reactions.
出处
《解放军药学学报》
CAS
CSCD
2017年第3期287-289,共3页
Pharmaceutical Journal of Chinese People's Liberation Army
关键词
丙戊酸钠
血药浓度
临床药师
valproate
blood drug concentration
clinical pharmacists
