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目的研究丙戊酸钠血药浓度的监测,为临床合理用药提供参考。方法收集福州总医院2015年4月—2016年3月期间进行丙戊酸钠血药浓度分析的129例癫痫患者的分析报告,临床药师结合患者病情根据不同浓度范围进行分析,并对其分析报告进行统计分析。结果根据不同浓度范围,临床药师提出4种不同的分析意见,其中建议调整丙戊酸钠给药剂量的32例,建议维持丙戊酸钠给药剂量的69例,建议增、减其他抗癫痫药物的20例,建议调整其他非抗癫痫的用药8例。对于浓度<50μg·ml~(-1)的分析报告,分析建议中调整丙戊酸钠给药剂量的建议接受度最高,差异有统计学意义(P<0.05);对于浓度为50~100μg·ml~(-1)的分析报告,分析建议中维持丙戊酸钠给药剂量的建议接受度最高,差异有统计学意义(P<0.05);而对于浓度>100μg·ml~(-1)的分析报告,临床药师和临床医师均认为应调整丙戊酸钠的给药剂量或通过调整抗癫痫治疗方案,避免不良反应的发生。结论通过个体化的血药浓度分析,临床药师加强了与临床医师的合作,为提高临床疗效,减少不良反应的发生提供了有利的帮助。
Objective To study the monitoring of plasma concentration of valproate and provide reference for clinical rational drug use. Methods A total of 129 cases of epilepsy patients who underwent valproate sodium plasma concentration analysis were collected from April 2015 to March 2016 in Fuzhou General Hospital. Clinical pharmacists combined with their disease status were analyzed according to different concentration ranges. The analysis report conduct statistical analysis. Results According to the different concentration range, clinical pharmacists put forward four different opinions. Among them, 32 cases were recommended to adjust the dosage of sodium valproate. It is recommended to maintain the dosage of sodium valproate in 69 cases. It is recommended to add other anti-epilepsy Drugs in 20 cases, it is recommended to adjust the other non-anti-epileptic medication in 8 cases. For the analysis report of <50μg · ml -1, the recommended acceptance for adjusting the dose of sodium valproate was the highest in the analysis suggestion (P <0.05); for the concentration of 50 ~ 100μg · ml ~ (-1), the recommended acceptance level of sodium valproate in the analysis suggestion was the highest (P <0.05), while for the concentration> 100μg · ml ~ (-1) Analysis report, clinical pharmacists and clinicians agree that the dosage of sodium valproate should be adjusted or by adjusting the anti-epileptic treatment program to avoid the occurrence of adverse reactions. Conclusion Through the analysis of individualized plasma concentration, clinical pharmacists have strengthened their cooperation with clinicians and provided favorable help for improving clinical efficacy and reducing the incidence of adverse reactions.