年龄 体重 剂量对癫癎儿童丙戊酸钠血药浓度的影响

Influence of age, body weight and dose on sodium valproate plasma concentrations in children with epilepsy

摘要:

目的：年龄、体重、剂量是丙戊酸钠血药浓度的重要影响因素,它们之间是否存在交互效应以及交互效应对血药浓度有无影响还不清楚。该研究在探讨交互效应的基础上评价年龄、体重、剂量对丙戊酸钠血药浓度的影响情况。方法：132例儿童癫癎病人口服相应剂量丙戊酸钠并测定血药浓度。使用方差分析、相关分析、多元逐步回归分析等研究年龄、体重、剂量与丙戊酸钠血药浓度之间的数量关系。结果：方差分析发现年龄(F=8.630,P<0.01)、体重(F=3.650,P<0.05)、剂量(F=11.720,P＜0.01)及年龄与剂量(F=2.484,P＜0.05)、年龄、体重与剂量(F=4.923,P＜0.01)之间的交互效应对血药浓度影响有显著或极显著统计学意义。回归分析发现剂量、体重进入回归方程。结论：年龄(4月~6岁)、体重(5~25 kg)、剂量(每日10~30 mg/kg)及年龄(4月~6岁)与剂量(每日10~30 mg/kg)，年龄(4月~6岁)、体重(5~25 kg)与剂量(每日10~30 mg/kg)之间的交互作用对血药浓度有影响。用药要综合考虑这些因素影响。

Abstract:

OBJECTIVE: Age, body weight and dose have been shown as important influencing factors for sodium valproate plasma concentrations. However it is unclear whether there is interaction among them and whether the interaction could influence sodium valproate plasma concentrations. This study aimed to evaluate the influence of age, body weight and dose on plasma concentrations of sodium valproate and the interaction among them.METHODS: One hundred and thirty-two children with epilepsy (age: 4 months-6 years, weight: 5-25 kg) were enrolled. Sodium valproate was administered at the dosage of 10-30 mg/kg.d. Plasma concentrations of sodium valproate were measured by high-performance liquid chromatography 3-5 days after administration. The relationship of sodium valproate plasma concentrations with age, body weight, and dose of sodium valproate was examined using variance analysis, pearson correlation analysis and stepwise regression analysis. RESULTS: Age (F=8.630, P<0.01), body weight (F=3.650, P<0.05) and dose of sodium valproate (F=11.720, P<0.01) were influencing factors for sodium valproate plasma concentrations. The interaction between age and oral dose (F=2.484, P<0.05) and the interaction of age and body weight with oral dose (F=4.923, P<0.01) had significant effects on sodium valproate plasma concentrations. Stepwise regression analysis showed that dose of sodium valproate and body weight were entered to the regression equation.CONCLUSIONS: Age, body weight and dose of sodium valproate as well as the interactions between age and dose and between age, body weight and dose were influencing factors for valproate plasma concentrations.