Tsatsakis A M, Psillakis T, Paritsis N
Laboratory of Toxicology, Medical School, University of Crete, Voutes, Greece.
J Clin Psychopharmacol. 2000 Oct;20(5):560-73. doi: 10.1097/00004714-200010000-00012.
Phenytoin (PHT) levels were determined in sections of head hair taken from 60 patients (34 males and 26 females), aged 5 to 69 years, who were regularly receiving the drug. The hair sectional analysis included dissolution, liquid phase extraction procedures, and immunoassay (Abbott TDx) or high-pressure liquid chromatography (HPLC) analytical techniques. The values of PHT levels in the hair from the first section (close to the hair root) to the fifth section for female patients were 18.0, 15.2, 13.1, 11.6, and 10.7 microg/g, respectively, according to HPLC measurements. There were no significantly different results obtained using the immunoassay technique, according to which the mean values of PHT in the hair sections were 17.9, 15.2, 13.1, 11.9, and 10.9 microg/g, respectively, from the first to the fifth sections. The corresponding mean values for male patients by HPLC and immunoassay techniques, respectively, were 17.9, 15.0, 12.5, 12.1, and 12.3 microg/g and 17.8, 14.9, 12.2, 11.9, and 121 microg/g. Generally, a reduction of drug concentrations in hair from the first to the subsequent segments was observed. The hair PHT concentrations were found to be dependent on the dosage (by fluorescence polarization immunoassay: r = 0.987, p < or = 0.02; by HPLC: r = 0.988, p < or = 0.02). Mean dose and assay outcome values by hair color and correlation between hair PHT mean values, daily mean doses of the drug, and patients' age are presented. The differences among doses according to hair color were significant. PHT hair profiles from female and male patients compared with the mean +/- SD concentrations of the hair sections are discussed. The data indicate the possible use of hair section testing as a marker of the dosage history and the compliance of patients receiving long-term treatment with PHT.
对60例年龄在5至69岁、长期规律服用苯妥英（PHT）的患者（34名男性和26名女性）的头发样本进行了PHT水平检测。头发分段分析包括溶解、液相萃取步骤以及免疫分析（雅培TDx）或高压液相色谱（HPLC）分析技术。根据HPLC测量结果，女性患者从第一节（靠近发根）到第五节头发中PHT水平的值分别为18.0、15.2、13.1、11.6和10.7微克/克。使用免疫分析技术得到的结果无显著差异，根据该技术，从第一节到第五节头发中PHT的平均值分别为17.9、15.2、13.1、11.9和10.9微克/克。男性患者通过HPLC和免疫分析技术得到的相应平均值分别为17.9、15.0、12.5、12.1和12.3微克/克以及17.8、14.9、12.2、11.9和12.1微克/克。一般来说，观察到头发中药物浓度从第一节到后续节段逐渐降低。发现头发中PHT浓度取决于剂量（通过荧光偏振免疫分析：r = 0.987，p≤0.02；通过HPLC：r = 0.988，p≤0.02）。列出了按头发颜色划分的平均剂量和检测结果值，以及头发中PHT平均值、药物每日平均剂量和患者年龄之间的相关性。不同头发颜色的剂量差异显著。讨论了女性和男性患者的PHT头发分布图与头发节段平均±标准差浓度的比较。数据表明，头发分段检测可能作为长期接受PHT治疗患者剂量史和依从性的标志物。
