儿科药学杂志2024，Vol.30Issue(8)：1-5,5.DOI:10.13407/j.cnki.jpp.1672-108X.2024.08.001
基于癫痫患儿治疗药物监测的奥卡西平活性代谢产物血药浓度影响因素分析
Influencing Factors on Blood Concentration of Active Metabolites of Oxcarbamazepine Based on Therapeutic Drug Monitoring in Children with Epilepsy
摘要
Abstract
Objective:To explore the influencing factors on blood concentration of active metabolites 10-monohydroxy carbamazepine(MHD)of oxcarbamazepine based on therapeutic drug monitoring in children with epilepsy.Methods:A total of 328 epileptic children aged from 0 to 16 years who regularly took oxcarbazepine were collected from Aug.2022 to Aug.2023.The blood concentration of active metabolites MHD of oxcarbamazepine were determined by high performance liquid chromatography-tandem mass spectrometry.The correlation between daily dose,body mass and blood concentration was analyzed.Effects of age,gender,creatinine clearance rate,urea and combined use of antiepileptic drugs(AEDs)on blood concentration of MHD were investigated.Results:By multiple linear regression analysis,the effects of each factor on blood concentration of MHD were as follows:daily dose＞body mass＞daily per kg dose＞age＞creatinine clearance rate＞gender＞urea.Blood concentration of MHD was positively correlated with daily dose and daily per kg dose.The results of concentration dose ratio(CDR)in infants were significantly lower than those in children and adolescents(P＜0.05).There was no significantly difference in CDR of MHD between different genders(t=1.422,P＞0.05).CDR of MHD was positively correlated with creatinine clearance rate.Meanwhile,the CDR of creatinine clearance rate＞120 mL/min group were significantly higher than those of＜80 mL/min group and from 80 to 120 mL/min group(t=-4.539,P＜0.01;t=-5.002,P＜0.01).The CDR of urea＜2.9 mmol/L group were significantly higher than those from 2.9 to 8.2 mmol/L group(t=2.108,P＜0.05).The CDR of MHD monotherapy group were significantly higher than those of combined enzyme inhibited AEDs group(U=5,564.00,P＜0.05).Conclusion:The factors influencing the blood concentration of MHD are complex and the pharmacokinetics vary greatly among different individuals.Daily dose,body mass,age,creatinine clearance rate,urea and combined enzyme inhibition of AEDs are important factors that affect blood concentration of MHD.Therefore,it is necessary to monitor the blood concentration of oxcarbazepine in clinical antiepileptic treatment to provide individualized medication regimen support.关键词
奥卡西平/10-羟基卡马西平/血药浓度/影响因素/儿童Key words
oxcarbazepine/10-monohydroxy carbamazepine/blood concentration/influencing factors/children分类
医药卫生引用本文复制引用
马英华,安娜,安志华,赵宜乐..基于癫痫患儿治疗药物监测的奥卡西平活性代谢产物血药浓度影响因素分析[J].儿科药学杂志,2024,30(8):1-5,5.基金项目
河北省卫生健康委员会2021年度医学科学研究课题计划项目,编号20211469. （）
