影响拉莫三嗪血药浓度因素的研究Factors in Plasma Lamotrigine Concentrations
倪穗琴,张晨,热孜万·艾尔肯,邱畅,温预关
NI Suiqin,ZHANG Chen,REZIWAN·Aierken,QIU Chang,WEN Yuguan
摘要(Abstract)：
目的本研究旨在分析影响拉莫三嗪血药浓度的相关因素,确保药物疗效及用药安全。方法回顾性收集2011-05~2013-12期间广州市脑科医院应用拉莫三嗪患者的血药浓度检测数据。102例患者共监测153次,收集的患者数据包括患者的基本情况、生理生化指标,给药剂量、联合用药情况等。以逐步回归分析法处理收集的数据,分析各类因素是如何影响拉莫三嗪血药浓度的。结果应用逐步回归法分析影响拉莫三嗪血药浓度的各类因素,结果显示拉莫三嗪的血药浓度与给药剂量的关系最为密切,同时还与患者的肝肾功能情况、合并用药显著相关(P<0.01),其中增大剂量或加用丙戊酸钠、奥卡西平、舍曲林、氟西汀等可显著提高拉莫三嗪的血药浓度;肝肾功能减弱或加用卡马西平、奎硫平、利培酮等可明显降低血药浓度。结论影响拉莫三嗪血药浓度的因素较多,需关注联合用药情况,加强拉莫三嗪的血药浓度监测,以确保疗效,减少毒副反应的发生。
OBJECTIVE To analyze factors influencing lamotrigine serum concentration. METHODS Various types of epilepsy treated in Guangzhou Brain Hospital from May 2011 to December 2013 were collected in this study,153 survey samples of 102 patients were collected,including age,gender,liver and kidney functions and usage of lamotrigine. RESULTS The factors could affect lamotrigine serum concentrations were analyzed by stepwise regression method. The results showed the lamotrigine plasma concentration was most closely related with its administration dosage,and also significant related with the liver,kidney function of the patients and combination with other drugs( P < 0. 01). Increasing the dosage of lamotrigine or combined with sodium valproate,oxcarbazepine,sertraline,fluoxetine,etc. could significantly increase the plasma concentration of lamotrigine; decline of liver and kidney function or combined with carbamazepine,quetiapine,risperidone,etc. cloud significantly reduce the plasma concentration. CONCLUSION Serum concentration of lamotrigine can affect by many factors. Drug combination application and serum concentration monitoring of lamotrigin should be focused,so as to ensure the effectiveness and to reduce its adverse drug reaction.
关键词(KeyWords)：
拉莫三嗪;血药浓度;药物相互作用;药代动力学
lamotrigine;plasma concentrations;drug interactions;pharmacokinetic
基金项目(Foundation):
作者(Author):
倪穗琴,张晨,热孜万·艾尔肯,邱畅,温预关
NI Suiqin,ZHANG Chen,REZIWAN·Aierken,QIU Chang,WEN Yuguan
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