| 摘要: |
| ［摘要］ 目的 了解抗癫痫治疗患儿血清丙戊酸（VPA）浓度分布特征并分析其影响因素。方法 回顾性分析2021年1月至2024年6月在广州市妇女儿童医疗中心柳州医院接受丙戊酸钠治疗的664例癫痫患儿的临床资料。采用荧光免疫层析法测定患儿治疗期间的血清VPA浓度（2 514例次），分析年龄、性别、给药剂量、药物剂型以及联合用药情况等因素对血清VPA浓度的影响。分析血清VPA浓度与疗效的关联性。记录患儿治疗期间不良反应的发生情况。结果 共检测2 514例次，平均血清VPA浓度为（58.86±26.11）μg·mL-1。血清VPA浓度50～100 μg·mL-1者1 419例次（56.44%），<50 μg·mL-1者936例次（37.23%），>100 μg·mL-1者159例次（6.32%）。年龄、给药剂量、药物剂型以及联合用药情况对血清VPA浓度有显著影响（P<0.05），性别对血清VPA浓度无显著影响（P>0.05）。患儿血清VPA浓度与疗效有显著关联（P<0.05）。血清VPA浓度为50～100 μg·mL-1患儿中显效和有效的总人数比例为83.16%。39例患儿（51例次）血清VPA浓度超过警戒值（120 μg·mL-1），其中2例发生肝功能损伤，其余患儿无不良反应发生。结论 抗癫痫治疗患儿血清VPA浓度与患儿年龄、给药剂量、药物剂型以及联合用药情况有关，临床应定期监测血清VPA浓度，制订个性化治疗方案，提高疗效。 |
| 关键词: 癫痫 儿童 丙戊酸 血清药物浓度 影响因素 |
| DOI：10.3969/j.issn.1674-3806.2026.05.15 |
| 分类号:R 971 |
| 基金项目:广西壮族自治区卫生健康委员会科研课题（编号：Z20200713） |
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| Analysis on distribution characteristics of serum concentration of valproic acid in 664 pediatric patients receiving antiepileptic treatment and their influencing factors |
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YANG Ni1, XIE Wei1, FU Lixiang1, LU Caihong1, MENG Lidi1, ZENG Xianzhi2
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1.Department of Pharmacy, Guangzhou Women and Children′s Medical Center Liuzhou Hospital(Liuzhou Maternity and Child Healthcare Hospital), Liuzhou 545616, China; 2.Department of Pharmacy, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530000, China
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| Abstract: |
| ［Abstract］ Objective To understand the distribution characteristics of serum concentration of valproic acid(VPA) in pediatric patients receiving antiepileptic treatment and to analyze their influencing factors. Methods A retrospective analysis was conducted on the clinical data of 664 pediatric patients with epilepsy who received sodium valproate treatment in Guangzhou Women and Children′s Medical Center Liuzhou Hospital from January 2021 to June 2024. The serum concentration of VPA in the pediatric patients during the treatment period was determined by using fluorescence immunochromatography(2 514 cases). The effects of factors including age, gender, dosage, dosage form and combination medication on the serum concentration of VPA were analyzed. The correlation between the serum concentration of VPA and its therapeutic effect was analyzed. The occurrence of adverse reactions in the pediatric patients during the treatment period was recorded. Results The serum concentration of VPA was determined in a total of 2 514 cases, and the average serum concentration of VPA was (58.86±26.11)μg·mL-1. The serum concentration of VPA ranged from 50 to 100 μg·mL-1 in 1 419 cases(56.44%), and <50 μg·mL-1 in 936 cases(37.23%), and >100 μg·mL-1 in 159 cases(6.32%). Age, dosage, dosage form and combination medication had significant effects on the serum concentration of VPA(P<0.05), while gender had no significant effects on the serum concentration of VPA(P>0.05). The pediatric patients′ serum concentration of VPA were significantly correlated with their therapeutic effects(P<0.05). Among the pediatric patients with the serum concentration of VPA ranging from 50 to 100 μg·mL-1, the proportion of the pediatric patients with markedly effective medication and with effective medication was 83.16%. The serum concentration of VPA in 39 pediatric patients(a total of 51 cases) exceeded the warning value(120 μg·mL-1), among whom 2 pediatric patients had liver function injury, and the other pediatric patients had no adverse reactions. Conclusion Serum concentration of VPA in pediatric patients undergoing antiepileptic treatment is related to their age, dosage, dosage form and combination medication. In clinical practice, the serum concentration of VPA should be monitored regularly to formulate personalized treatment plans and improve therapeutic effects. |
| Key words: Epilepsy Children Valproic acid(VPA) Serum drug concentration Influencing factors |
