摘要
目的分析不同品种丙戊酸钠尤其是集采品种对其体内血药浓度的影响,以及患者使用丙戊酸钠的安全性。方法采用回顾性研究方法,收集2023年1月至2024年12月常州市第二人民医院住院患者行丙戊酸钠血药浓度监测的病例,分析丙戊酸钠血药浓度的影响因素,对比用药前后患者的肝酶、血小板水平的变化。结果共纳入195例患者,集采品种丙戊酸钠浓度达标率最高。另外,剂型、给药方式、联合用药(碳青霉烯类药物、苯巴比妥)、日剂量和用药天数会显著影响丙戊酸钠血药浓度(P均<0.05)。服用丙戊酸钠片后丙氨酸氨基转移酶(ALT)出现显著升高,但未出现肝损伤。丙戊酸钠片、丙戊酸钠缓释片用药后血小板水平显著升高(P分别为<0.001,0.023)。结论集采品种丙戊酸钠可以有效地使用,由于还有其他因素的影响,因此治疗过程中仍需加强监测,同时临床医生应结合患者不同的情况优化丙戊酸钠的给药方案,以提高丙戊酸钠血药浓度的达标率,提高临床疗效和用药安全性。
Objective To analyze the factors influencing the blood concentration of different dosage forms of sodium valproate in vivo,especially the procured through centralized procurement,and to assess the safety of using these forms of sodium valproate.Methods A retrospective study was performed on the medical records of inpatients at the Second People's Hospital of Changzhou who underwent blood concentration monitoring of sodium valproate from January 2023 to December 2024.The study statistically analyzed the factors affecting blood concentrations of sodium valproate and compared changes in liver enzyme levels and platelet counts of patients before and after medication.Results A total of 195 cases were collected,and the highest rate of achieving the target concentration of sodium valproate was procured through centralized procurement.Furthermore,the dosage form,administration route,concomitant medications(including carbapenems and phenobarbital),daily dose,and duration of treatment significantly influenced the blood concentration of sodium valproate(all P<0.05).Although ALT levels significantly increased after taking sodium valproate tablets,there was no evidence of liver damage.Both sodium valproate tablets and sodium valproate retard tablets demonstrated significant increases in platelet count after taking the medication(P<0.001 and P=0.023).Conclusion The variety of sodium valproate acquired through centralized procurement is effective for use.However,due to the influence of various factors,it remains necessary to intensify monitoring during treatment.At the same time,clinicians should optimize the dosing regimen of sodium valproate based on the different conditions of patients to improve the achievement rate of target sodium valproate blood concentration,thereby enhancing clinical efficacy and ensuring medication safety.
作者
王静霞
何小梅
WANG Jingxia;HE Xiaomei(Department of Pharmacy,The Second People's Hospital of Changzhou,the Third Affiliated Hospital of Nanjing Medical University,Changzhou 213000,China)
出处
《中国处方药》
2025年第23期75-79,共5页
Journal of China Prescription Drug
关键词
丙戊酸钠
血药浓度
影响因素
联合用药
集中带量采购
Sodium valproate
Blood concentration
Influential factors
Drug combination
Centralized procurement
