Moosa R S, McFadyen M L, Miller R, Rubin J
Department of Pharmacology, University of Durban-Westville, South Africa.
Eur J Clin Pharmacol. 1993;45(4):297-301. doi: 10.1007/BF00265944.
The aim of this study was to investigate the use of carbamazepine in the treatment of neuralgic pain and to determine a therapeutic plasma concentration range for carbamazepine in neuralgias. The relation between plasma concentration and the response to treatment (reduction in pain) was examined by logistic regression analysis of carbamazepine and its metabolites, the epoxide, the diol, and 2-hydroxycarbamazepine. The plasma concentrations of carbamazepine, the epoxide, and the diol were significantly related to the probability of a 25% reduction in pain. Only carbamazepine was significantly related to the probability of 50% and 75% pain reduction. However, multiple regression analysis with backward elimination of the data showed a significant correlation between both carbamazepine and the epoxide with regard to the probability of 50% and 75% reductions in pain. This confirms the previous finding that the epoxide has antineuralgic properties [Tomson and Bertilsson 1984]. The therapeutic plasma concentration range for carbamazepine in neuralgias, defined as the range of concentrations that would be expected to provide a 25-75% reduction in pain in 50% of patients, was 2-7 micrograms.ml-1 (HPLC) or 5-17 micrograms.ml-1 (EMIT).
本研究的目的是调查卡马西平在治疗神经痛中的应用，并确定卡马西平在神经痛中的治疗血浆浓度范围。通过对卡马西平及其代谢产物环氧化物、二醇和2-羟基卡马西平进行逻辑回归分析，研究了血浆浓度与治疗反应（疼痛减轻）之间的关系。卡马西平、环氧化物和二醇的血浆浓度与疼痛减轻25%的概率显著相关。只有卡马西平与疼痛减轻50%和75%的概率显著相关。然而，对数据进行向后排除的多元回归分析表明，卡马西平和环氧化物在疼痛减轻50%和75%的概率方面均存在显著相关性。这证实了先前的发现，即环氧化物具有抗神经痛特性[汤姆森和贝蒂尔松，1984年]。神经痛中卡马西平的治疗血浆浓度范围定义为预计能使50%的患者疼痛减轻25%-75%的浓度范围，为2-7微克·毫升-1（高效液相色谱法）或5-17微克·毫升-1（酶放大免疫测定技术）。
