CARBAMAZEPINE PLASMA-LEVELS IN CHILDREN AND ADULTS - INFLUENCE OF AGE, DOSE, AND ASSOCIATED THERAPY
CARBAMAZEPINE PLASMA-LEVELS IN CHILDREN AND ADULTS - INFLUENCE OF AGE, DOSE, AND ASSOCIATED THERAPY
复制标题
DOI：
10.1097/00007691-198002040-00003
复制
发表时间：
1980-01-01
影响因子：
2.5
通讯作者：
VITALI, A
中科院分区：
文献类型：
--
作者：
BATTINO, D;BOSSI, L;VITALI, A
对326例长期治疗的癫痫患者（207例19岁以下儿童和青少年，119例19-45岁成人）的567次连续常规CBZ测定结果进行回顾性分析，评价剂量/kg、年龄和相关治疗对卡马西平（CBZ）血药浓度和水平/剂量（L/D）比值的影响。在儿科组中，CBZ给药剂量与血浆水平之间无相关性。在成人中，相关性显著，但各给定剂量下的血浆浓度分布广泛，因此该关系无预测价值。CBZ L/D比值随年龄增加呈线性增加，最高可达19岁。年龄为0-3岁、4-9岁、10-15岁的患者与成人（19-45岁）之间的CBZ L/D平均比值存在显著差异。青少年（16-18岁）的平均CBZ L/D比值与成人非常相似。相关抗癫痫治疗影响CBZ L/D比值，与CBZ单药治疗相比，同时接受苯妥英、扑米酮和苯巴比妥治疗的患者L/D比值显著降低。年龄和相关治疗对CBZ L/D比值的影响在相关治疗和年龄同质的亚组中也具有统计学显著性。在> 4岁的受试者中，观察到CBZ每日D/kg和L/D比值之间存在显著负相关，表明高剂量CBZ吸收受损。CBZ L/D比值在长期治疗的癫痫患者中的巨大个体间变异性得到证实。由于无法预测个体患者在给定剂量后将达到的血浆浓度，因此常规监测CBZ血浆水平非常有用，特别是在儿科患者和接受多种治疗的患者中。
The effects of dose/kg, age and associated therapy on carbamazepine (CBZ) plasma concentrations and level/dose (L/D) ratios were evaluated retrospectively on 567 consecutive routine CBZ determinations from 326 chronically treated epileptic patients (207 children and adolescents less than 19 yr old and 119 adults between 19-45 yr of age). In the pediatric group there was no correlation between the administered CBZ dose and the plasma levels. In the adults the correlation was significant but the wide scattering of the plasma concentrations at each given dose was such that the relationship had no predictive value. The CBZ L/D ratio increased linearly with age in patients up to 19 yr. Significant differences in mean CBZ L/D ratios were found between patients aged 0-3 yr, 4-9 yr, 10-15 yr and adults (19-45 yr). The adolescents (16-18 yr) had a mean CBZ L/D ratio very similar to the adults. Associated antiepileptic therapy affected the CBZ L/D ratio, which was significantly reduced in patients also receiving phenytoin, primidone and phenobarbital, as compared to those on CBZ monotherapy. The effects of age and associated therapy on the CBZ L/D ratio were also statistically significant in subgroups homogeneous for associated therapy and age. In subjects > 4 yr of age, a significant negative correlation was observed between CBZ daily D/kg and L/D ratios, suggesting an impaired absorption of CBZ at high doses. The great interindividual variability in CBZ L/D ratios in chronically-treated epileptic patients was confirmed. Because it is impossible to predict the plasma concentrations that will be attained in individual patients after a given dose, routine monitoring of CBZ plasma levels is very useful, especially in pediatric patients and in patients on polytherapy.