中国临床药学杂志2025，Vol.34Issue(5)：366-371,6.DOI:10.19577/j.1007-4406.2025.05.008
癫痫患儿左乙拉西坦血药浓度的影响因素研究
Influencing factors of blood concentrations of levetiracetam in pediatric patients with epilepsy
摘要
Abstract
AIM To investigate the influencing factors of blood concentrations of levetiracetam in pediatric patients with epilepsy.METHODS A total of 106 pediatric epilepsy patients treated at the hospital between October 2021 and July 2023 were enrolled as research subjects.The blood concentrations of levetiracetam in the pediatric patients were determined using high-performance liquid chromatography(HPLC).Based on the effective blood concentrations range of levetiracetam,the pediatric patients were categorized into groups with concentrations of 4-8 μg·mL-1,8-12 μg·mL-1,and 12-46 μg·mL-1.The total effective rates of different groups were compared.Clinical data relevant to the pediatric patients were collected to identify the factors influencing blood concentrations of levetiracetam in pediatric patients.A reference range of effective blood concentrations was determined.Concurrently,adverse drug reactions induced by levetiracetam monotherapy and combination therapy were monitored.RESULTS The total effective rates in the 12-46 μg·mL-1 and 8-12 μg·mL-1 groups were statistically significantly higher than that in the 4-8 μg·mL-1 group(P＜0.05).The highest total effective rate,at 88.24％,was observed in the 12-46 μg·mL-1 group.There were statistically significant differences in the blood concentrations of levetiracetam between pediatric patients grouped based on body mass index(BMI),hemoglobin(Hb),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),creatinine(Cr),dosage,and medication(P＜0.05).Multiple linear regression analysis results showed that dosage and combination of sodium valproate were factors influencing the blood concentrations of levetiracetam in pediatric patients with epilepsy(P＜0.05).According to the effective blood concentrations range,the reference range for effective blood concentrations of levetiracetam in pediatric patients with epilepsy was 4.45-14.78 μg·mL-1.Of the 106 pediatric cases,12 cases of adverse reactions were reported,with only 2 attributed to monotherapy.The incidence of adverse reactions was significantly higher in patients receiving combination therapy compared to monotherapy(P＜0.05).CONCLUSION The dosage and co-administration of sodium valproate are factors influencing the blood concentrations of levetiracetam in pediatric patients with epilepsy.The effective blood concentrations range of levetiracetam in pediatric patients with epilepsy is 4.45-14.78 μg·mL-1.Levetiracetam monotherapy demonstrates a superior safety profile compared to its use in polytherapy regimens.关键词
癫痫/儿童患者/左乙拉西坦/血药浓度/影响因素/有效血药浓度范围Key words
epilepsy/pediatric patients/levetiracetam/blood drug concentration/influencing factor/effective blood concentration range分类
临床医学引用本文复制引用
王志良,吴晓燕,范璐炜,戚利那..癫痫患儿左乙拉西坦血药浓度的影响因素研究[J].中国临床药学杂志,2025,34(5):366-371,6.基金项目
2023年杭州市医药卫生科技计划项目(编号B20230024) （编号B20230024）
2021年绍兴市上虞区科学技术局(社会发展项目) （社会发展项目）
