遗传因素与合用丙戊酸的南方癫痫患儿对拉莫三嗪疗效的相关性

发布时间：2018-04-29 15:25

本文选题：癫痫 + 丙戊酸　；参考：《实用医学杂志》2017年19期

【摘要】：目的探讨在合用丙戊酸(VPA)的儿童癫痫患者中,年龄、性别、体重、UGT1A4 142TG基因多态性等影响因素对拉莫三嗪(LTG)疗效的影响,并明确中国南方癫痫儿童患者LTG的有效血药浓度。方法选取2010年1月至2016年9月在广州市妇女儿童医疗中心神经内科就诊的癫痫患儿72例,均采用LTG+VPA联合治疗。采用液质联用法检测LTG的浓度,采用限制性片段长度多态性聚合酶链式反应法测定UGT1A4 142TG的基因型。采用卡方检验、非参数检验、Logistic回归分析等探讨各影响因素与LTG疗效的相关性及有效血药浓度。结果合用VPA时,年龄越小、体重越轻,其疗效相对差。男性较女性容易获得较好疗效。UGT1A4 142TG对LTG疗效无显著影响。合用VPA时,患儿LTG的有效血药浓度为2μg/m L。结论年龄显著影响LTG的疗效;合用VPA时,南方癫痫患儿LTG的有效血药浓度应2μg/m L;本研究能为中国南方癫痫儿童的个体化给药提供参考。
[Abstract]:Objective to investigate the effect of age, sex, weight and UGT1A4 142TG polymorphism on the efficacy of lamotriazine in children with epilepsy, and to determine the effective serum concentration of LTG in children with epilepsy in southern China. Methods from January 2010 to September 2016, 72 children with epilepsy were treated with LTG VPA. The concentration of LTG was detected by HPLC and the genotypes of UGT1A4 142TG were determined by restriction fragment length polymorphism polymerase chain reaction. Chi-square test, non-parametric test and logistic regression analysis were used to investigate the correlation between the influencing factors and the curative effect of LTG and the effective blood concentration. Results when combined with VPA, the younger the age, the lighter the body weight. Men were more likely to obtain better efficacy than women. UGT 1 A 4 142TG had no significant effect on the efficacy of LTG. When combined with VPA, the effective serum concentration of LTG was 2 渭 g / mL. Conclusion Age has a significant effect on the efficacy of LTG, and the effective serum concentration of LTG should be 2 渭 g / mL when combined with VPA. This study can provide a reference for individualized administration of epileptic children in southern China.
【作者单位】：南方医科大学南方医院药学部;广州市妇女儿童医疗中心药学部;中山大学临床药理研究所;广东省中医院药学部;广州医科大学附属脑科医院药学部;
【基金】：广东省科技计划项目(编号:2009B060700016)
【分类号】：R742.1

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