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目的:寻找丙戊酸药物浓度与CYP2C19基因多态性的关系,以便临床根据患者的基因型进行个体化给药。方法:运用血药浓度监测仪测定患者血药浓度和变性高效液相色谱法检测癫痫患者的CYP2C19基因多态性位点,对二者结果进行相关性分析。结果:51名汉族癫痫患者中有29名携带突变型CYP2C19基因,其中19名(65.52％)患者丙戊酸实际血药浓度较预期的血药浓度升高,血药浓度分布曲线右移。结论:CYP2C19参与丙戊酸的代谢。对于含突变型CYP2C19基因的患者应给予小剂量丙戊酸,以减少药物不良反应的发生和药物资源的浪费。
Objective: To find the relationship between valproic acid concentration and CYP2C19 gene polymorphism, so that it can be administered clinically according to the patient’s genotype. Methods: The serum concentration of CYP2C19 gene in patients with epilepsy was determined by plasma concentration monitor and denaturing high performance liquid chromatography (HPLC). The correlation between them was analyzed. RESULTS: Twenty-nine of 51 Han patients with epilepsy carried the mutated CYP2C19 gene. The actual plasma concentration of valproate in 19 (65.52%) patients was higher than the expected plasma concentration and the blood concentration profile shifted to the right. Conclusion: CYP2C19 is involved in the metabolism of valproic acid. Small doses of valproic acid should be given to patients with the mutant CYP2C19 gene to reduce adverse drug reactions and waste of medication.