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《Journal of Applied Clinical Pediatrics》 2009-12
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Blood Drug Concentration Monitoring of Sustained-Release Valproate Sodium in Children with Epilepsy

ZHANG Xu-hui,CAO Di,GAO Xuan,LI Zhi-ping(Department of Pharmacy,Children's Hospital of Fudan University,Shanghai 201102,China)  
Objective To explore the blood drug concentration monitoring of sustained-release valproate(DK)in children with epilepsy,focusing on the selection of sampling time and evaluation of the results.Methods Two hundred and seventy-one children taking DK and 155 children taking sodium valproate syrup(VPA Syr)were involved and their serum were taken when achieved steady state to determine the valproic acid level using fluorescence polarization immunoassay.They were divided into 4 groups,which were DK taken once daily group(DK qd group,126 children),DK taken once daily at night and sampled on morning group(DK qn group,26 children),DK taken every 12 h group(DK q12 h group,119 children),VPA Syr q12 h group(155 children).Determine the proportion of the blood drug concentration of each group below,ithin and above the therapeutic range for valproate(50-100 mg/L)were determined.The data were analyzed by t test.Results The Cmin of DK qd group were(73.09±19.91)mg/L,significantly lower from the serum concentration of DK qn and sampled on morning group [(94.94±25.44)mg/L](P0.01).The Cmin of DK q12 h group [(96.67±22.02)mg/L] were significantly higher than that of DK qd group(P0.01).The Cmin of VPA Syr q12 h group [(58.92±23.60)mg/L] were significantly lower than that of DK qd group(P0.01).The proportion of Cmin of DK qd group in the therapeutic range was 77.8%,while above and below the therapeutic range was 9.5% and 12.7%,respectively.The proportion of Cmin of DK q12 h group in the therapeutic range was 58.0%,while above and below the therapeutic range was 40.3% and 1.7%,respectively.The proportion of Cmin of VPA Syr q12 h group in the therapeutic range was 58.1%,while above and below the therapeutic range was 5.8%and 36.1%,respectively.The dose of DK qd group was(18.54±5.50)mg/(kg·d)(n=27),significantly lower than that of DK q12 h group [(23.39±6.50)mg/(kg·d),n=36](P0.01).The dose of VPA Syr q12 h was(24.81±5.98)mg/(kg·d)(n=155),the difference was not significant compared with that of DK q12 h group(P0.05).Conclusions DK qn should sampled at night before the night dose.The Cmin of DK q12 h was higher according to the therapeutic range,it's favorable range still needs clinical practice.
【CateGory Index】: R742.1
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