奥卡西平治疗成人癫痫发作的血药浓度与临床疗效和安全性的观察分析

发布时间：2018-06-02 15:38

  本文选题：癫痫 + 数据库　； 参考：《苏州大学》2014年硕士论文

【摘要】：目的 通过建立癫痫数据库,从中提取应用奥卡西平治疗的成人癫痫患者信息,观察及评价奥卡西平(Oxcarbazepine, OXC)在成人癫痫患者的治疗过程中,其活性代谢物10,11-二氢-10-基卡马西平(monhydroxycarbazepin, MHD)血药浓度与临床疗效及安全性的相关性,为临床工作中奥卡西平的合理应用提供依据。同时提高癫痫数据库整理管理经验,便于癫痫患者的长程管理治疗。 方法 收集2013年02月至2014年02月,苏州大学附属第二医院门诊及病房收治的确诊为癫痫的成人患者,同时将其录入成人癫痫数据库,详细记录患者姓名、年龄、身高、体重和联系方式等基本资料,以及用药种类、剂量,联合用药,药物相关不良反应等详细信息。从中提取接受奥卡西平治疗患者的数据资料,同时建立高效液相色谱法测定MHD稳态血药浓度,并随访其服药后相关不良反应及三个月后的临床疗效。分析血药浓度与给药剂量(药物剂量/重)之间的关系,探讨奥卡西平血药浓度与临床疗效的关系。 结果 癫痫数据库共收录了92例癫痫患者,提取其中接受奥卡西平治疗的的患者42例,其中男性28例、女性14例；年龄16～77岁,平均年龄(37.2±17.9)岁；身高(169.0±6.7)cm,体重(65.7士11.6)kg,BMI(23.0±3.5)。治疗总有效率为76.47%,血药浓度位于有效治疗窗内组的疗效为91.3%,低于有效治疗窗组为64.2%,经x2检验,有效治疗窗内组的疗效优于低于有效治疗窗组(P0.05)；给药剂量(药物剂量／体重)与血药浓度呈正相关,为一元一次线性回归关系,方程为C=0.275×D+6.86(R=0.402,P=0.03)。治疗组内共8例出现不良反应,发生率为19.0%,不良反应发生率低,且程度较轻。 结论 癫痫数据库的建立,有利于临床医师制定及实施个体化、规范化的抗癫痫治疗方案,提高药物保留率及治疗疗效。奥卡西平治疗癫痫疗效显著,不良反应发生率低,通过血药浓度检测,可有助于临床医生个体化给药,对于临床癫痫症状的控制有良好的指导作用。
[Abstract]:Purpose Through the establishment of epilepsy database, the information of adult epileptic patients treated with oxcarbazepine (Oxcarbazepine) was extracted, and the course of treatment of adult epilepsy patients was observed and evaluated. The correlation between the serum concentration of MHDand the clinical efficacy and safety of its active metabolite 101- dihydro-10-dihydrocarbazepin (MHD) provides a basis for the rational use of oxcarbazepine in clinical work. At the same time, we can improve the management experience of epilepsy database, and facilitate the long-range management treatment of epilepsy patients. Method From February 2013 to February 2014, adult patients who were diagnosed with epilepsy in outpatient and ward of the second affiliated Hospital of Suzhou University were collected and recorded in the adult epilepsy database, and the names, ages, height of the patients were recorded in detail. Basic information such as body weight and contact information, as well as drug use, dosage, combination, drug-related adverse reactions and other details. The data of patients treated with oxcarbazepine were extracted, and the steady-state blood concentration of MHD was determined by HPLC, and the related adverse reactions were followed up and the clinical effect after 3 months was followed up. The relationship between serum concentration and dosage (dosage / weight) was analyzed, and the relationship between serum concentration of oxcarbazepine and clinical efficacy was discussed. Result A total of 92 epileptic patients were included in the Epilepsy Database, 42 of whom were treated with oxcarbazepine, including 28 males and 14 females, aged 1677 years with an average age of 37.2 卤17.9 years, with a height of 169.0 卤6.7 cm and a body weight of 65.7 卤11.6 kg / kg BMI23.0 卤3.5%. The total effective rate of treatment was 76.47. The effect of blood drug concentration in the effective treatment window group was 91.3, which was lower than that in the effective treatment window group (64.22.x2 test). The effective therapeutic effect in the intrawindow group was better than that in the effective window group, and the dose (drug dose / body weight) was positively correlated with the concentration of the drug in the blood, which was a linear regression equation with a equation of 0.275 脳 D 6.86RX 0.402Pu 0.03ng.The effect was better than that in the effective window group (P 0.05), and the dose of the drug (dosage / body weight) was positively correlated with the concentration of the drug in the blood. In the treatment group, there were 8 cases of adverse reactions, the incidence rate was 19.0, the incidence of adverse reactions was low and the degree was mild. Conclusion The establishment of epilepsy database is helpful for clinicians to formulate and implement individualized antiepileptic therapy and to improve drug retention rate and therapeutic effect. The efficacy of oxcarbazepine in the treatment of epilepsy is significant and the incidence of adverse reactions is low. The detection of serum concentration of oxcarbazepine can be helpful to the individual administration of the drug by clinicians and has a good guiding effect on the control of clinical epileptic symptoms.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.1
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本文编号：1969301