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目的:研究丙戊酸钠治疗癫痫的量-效关系,为临床癫痫患儿合理应用丙戊酸钠提供参考。方法:回顾性分析我院采用荧光偏振免疫分析法测定的273例癫痫患儿血清丙戊酸浓度及其使用的丙戊酸钠剂量。结果:要达到相似的血清丙戊酸浓度,不同年龄组的癫痫患儿丙戊酸钠给药剂量有差异,1～3岁患儿所需的剂量最大。服用相似剂量不同剂型的丙戊酸钠,缓释片的平均血药浓度明显高于溶液剂和普通片剂。血清丙戊酸浓度与按体表面积计算的日剂量相关性优于按体质量计算的日剂量。结论:血清丙戊酸浓度与剂量相关性差,个体差异大,临床上在使用丙戊酸钠治疗癫痫患儿时,应监测血药浓度并实行个体化给药。
Objective: To study the dose-response relationship of sodium valproate for the treatment of epilepsy and to provide a reference for rational use of sodium valproate in children with clinical epilepsy. Methods: The serum valproic acid concentration in 273 children with epilepsy and the dose of sodium valproate used in our hospital by fluorescence polarization immunoassay were retrospectively analyzed. RESULTS: To achieve similar serum valproate concentrations, doses of sodium valproate in children of different age groups differed in their doses, with the highest dose required for children 1-3 years of age. Taking a similar dose of different formulations of sodium valproate, sustained-release tablets, the average plasma concentration was significantly higher than the solution and ordinary tablets. The correlation between serum valproic acid concentration and daily dose calculated by body surface area was better than daily dose calculated by body weight. Conclusion: Serum valproic acid concentration and dose-related poor, individual differences, the clinical use of sodium valproate in children with epilepsy, the blood concentration should be monitored and the implementation of individualized administration.