Yukawa E, Suzuki A, Higuchi S, Aoyama T
Department of Hospital Pharmacy, Kyushu University Hospital, Faculty of Medicine, Kyushu University, Japan.
J Clin Pharm Ther. 1991 Aug;16(4):291-7. doi: 10.1111/j.1365-2710.1991.tb00317.x.
The effects of age and co-medication on steady-state valproic acid (VPA) level/dose (L/D) ratios were evaluated retrospectively in 382 paediatric patients. The VPA L/D ratio increased significantly with age up to 15 years of age in patients on monotherapy (L/D = 0.149 x AGE + 2.708, n = 192, r = 0.549, P less than 0.001). In patients taking three or more anti-epileptic drugs, including VPA, there was no such effect. Associated anti-epileptic therapy affected the VPA L/D ratio, which was significantly reduced in patients on polytherapy as compared to patients on monotherapy. Therefore, routine monitoring of VPA serum levels would be extremely useful, especially in the paediatric age group, and in patients who require associated anti-epileptic medication.
回顾性评估了382例儿科患者年龄及合并用药对稳态丙戊酸（VPA）血药浓度/剂量（L/D）比值的影响。单药治疗的患者中，VPA的L/D比值在15岁之前随年龄显著增加（L/D = 0.149×年龄 + 2.708，n = 192，r = 0.549，P＜0.001）。在服用包括VPA在内的三种或更多抗癫痫药物的患者中，未观察到这种效应。联合抗癫痫治疗影响VPA的L/D比值，与单药治疗患者相比，联合治疗患者的该比值显著降低。因此，常规监测VPA血清水平非常有用，尤其在儿科年龄组以及需要联合抗癫痫药物治疗的患者中。
