摘要
目的探讨不同丙戊酸钠血药浓度对小儿癫痫病患者中毒反应的影响。方法回顾性分析2014年5月~2017年6月期间入院经丙戊酸钠治疗的128例癫痫患儿病例资料,均采用高效液相色普法进行丙戊酸钠血药浓度监测。根据首次丙戊酸钠血药浓度分三组,59例<50μmol/mL纳入A组;60例在50~100μmol/mL纳入B组;9例>100μmol/mL纳入C组;分析各组临床疗效及中毒反应情况。结果三组不同丙戊酸钠血药浓度所达到的临床疗效存在统计学差异(P<0.01);B组总有效率明显高于其他两组,组间差异有统计学意义(P<0.05)。C组患儿肝功能指标(ALT、AST、GGT及TP)及肾功能指标(BUN、SCr)异常率明显较其余两组高,组间差异显著(P<0.05),C组其他不良反应发生率亦高于A组和B组,而B组又明显高于A组,组间差异显著(P<0.05)。结论不同丙戊酸钠血药浓度对小儿癫痫治疗效果有一定影响,高丙戊酸钠血药浓度会明显增加中毒反应发生率,临床应定期监测丙戊酸钠血药浓度,在提高疗效的同时注意降低中毒风险。
Objective To investigate the effect of different concentrations of sodium valproate on toxic reaction in children with epilepsy.Methods The clinical data of 128 children with epilepsy treated with sodium valproate in our hospital from May 2014 to June 2017 were retrospectively analyzed.High performance liquid chromatography was used to monitor the concentration of sodium valproate in serum.Children were divided into three groups according to different concentration,with 59 cases50μmol/mL in group A,60 cases 50-100μmol/mL in group B,9 cases 〉100μmol/mL in group C.The clinical efficacy and toxic reaction of each group were analyzed.Results The three groups with different concentrations of sodium valproate showed significant differences in the clinical efficacy（P〈0.01）.The total effective rate of group B was significantly higher than that in other two groups（P 〈0.05）.The abnormal rates of liver function indexes（ALT,AST,GGT and TP）and renal function indexes（BUN,SCr）in group C were significantly higher than those in the other two groups（P〈0.05）.The incidence of other adverse reactions in group C was higher than that group A and group B,in which group B was significantly higher than group A,with a significant difference（P〈0.05）.Conclusion Different plasma concentrations of sodium valproate have a certain impact on the treatment of children with epilepsy,and high plasma sodium valproate will increase the incidence of toxic reactions.Regular monitoring of serum concentration of sodium valproate is needed to reduce the risk of toxic reactions and improve the curative effect.
作者
罗琼
那尔布力.巴合提别克
茹凉
张晓英
严媚
LUO Qiong;NAERBULIO Bahetibieke;RU Liang;ZHANG Xiaoying;YAN Mei(Department of Pediatrics,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054;Department of Acupuncture and Massage,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《西部医学》
2018年第9期1348-1352,共5页
Medical Journal of West China
基金
新疆维吾尔自治区自然科学基金(2014211C130)
关键词
小儿癫痫
丙戊酸钠
血药浓度
中毒反应
影响效果
Children epilepsy
Sodium valproate
Blood concentration
Toxic reaction
Influence effect
