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目的:研究癫痫儿童拉莫三嗪(LTG)唾液与血清浓度的相关性。方法:在取得患儿及其家长知情同意的情况下,收集我院诊断为原发性或无需特殊病因治疗的症状性癫痫患儿,达稳态血药浓度后采集肘静脉血1 ml,并同时收集自然分泌状态下的唾液0.5 ml。使用反相高效液相色谱法(RP-HPLC)对血清及唾液浓度进行测定,数据分析采用统计学软件SPSS 11.5。结果:以LTG浓度(C)、LTG与内标的峰面积比(Y)作线性回归,分别得到血清浓度与唾液浓度的回归方程:Y=0.1824C-0.0080,r=0.9998;Y=0.1816C-0.0119,r=0.9997。共收集39例癫痫患儿的53个血清及唾液浓度样本,其中男27人,女12人,平均年龄7.86岁(1~15岁)。LTG血清浓度(x)和唾液浓度(y)之间的相关性如下:y=0.5607x-0.6074(n=53,r=0.9510,P<0.001)。LTG唾液与血清浓度的比值为0.42±0.11。结论:LTG血清和唾液之间有显著的相关性,可以用唾液替代血液对LTG进行治疗药物监测,由于唾液的采集简便无创,尤其适用于儿童患者。
Objective: To investigate the correlation between saliva and serum concentration of lamotrigine (LTG) in children with epilepsy. Methods: Children with symptomatic epilepsy diagnosed as primary or without special etiology were collected under informed consent of their children and their parents. 1 ml of elbow venous blood was collected after steady-state plasma concentration At the same time collecting natural secretion of saliva 0.5 ml. Serum and saliva concentrations were determined using reverse-phase high-performance liquid chromatography (RP-HPLC) using the statistical software SPSS 11.5. Results: The regression equation of serum concentration and saliva concentration was obtained by linear regression of LTG concentration (C), peak area ratio of LTG and internal standard (Y): Y = 0.1824C-0.0080, r = 0.9998; Y = 0.1816C- 0.0119, r = 0.9997. A total of 53 serum and saliva samples from 39 children with epilepsy were collected, including 27 males and 12 females, with an average age of 7.86 years (range 1-15 years). The correlation between LTG serum concentration (x) and saliva concentration (y) was as follows: y = 0.5607x-0.6074 (n = 53, r = 0.9510, P <0.001). The ratio of LTG saliva to serum concentration was 0.42 ± 0.11. CONCLUSIONS: There is a significant correlation between LTG serum and saliva. Saliva can be used instead of blood to monitor the therapeutic drug for LTG. Since saliva is easy to collect, it is especially suitable for children.