Retrospectively Analysis Of Blood Concentration Monitoring Of Qilu Hospital Of Shandong University Between 2006 And 2009

Objective:The blood concentration monitoring from 2006 to 2009 was analysed retrospectively to direct the use of medicine. Methods:The data as name, age, sex and monitoring results were summarized by analysing the blood concentration monitoring data of main anti-epileptic drugs and cyclosporine which were collected by qilu hospital of shandong university from 2006 to 2009. The data which was lower than effective concentration, equal to effective concentration and more than effective concentration was summarized. Results:Among the monitoring person-time of the 4 kind anti-epileptic drugs, the largest percentage (43.41%) was valproic acid sodium followed by carbamazepine (32.27%), phenytoin sodium (14.00%) and phenobarbital (10.33%). The monitoring person-time of 4 kind anti-epileptic drugs in the age of 0-3 and 60 years old was lowest, which was most in the age of 3～14 (436 person). The ratio of male who reached effective concentration of 4 kind anti-epilietic drugs was 31.14%, more than the ratio of female which was 12.17%. The ratio of male whose blood concentration was lower than effective concentration was 29.52%, more than the ratio of female which was 16.43%. The ratio of male whose blood concentration more than effective concentration was 6.33%, more than the ratio of female which was 4.87%. The ratio of monitoring one time was highest which was 94.26%, the ratio of monitoring two times was 4.54%, the ratio of monitoring three times was very low. The ratio of reaching effective concentration of 4 kind anti-epileptic drugs, carbamazepine was highest which was 57.97%, followed by phenobarbital (55.26%), valproic acid sodium (42.11%) and phenytoin sodium (16.41%). Among 1527 patients who were treated with 4 kind anti-epileptic drugs, the ratio of reaching effective concentration was 42.94%, the ratio of lower than effective concentration was 46.79%, and the ratio more than effective concentration was 10.27%. The monitoring results of cyclosporine were divided into 6 ranges.The ratio, which was in the range of lower than 50μg/L,350～450μg/L and more than 450μg/L, was 1.2%～3.3%, 6.6%～9.7% and 1.8%-7.6%. Most monitoring results were in the range of 50-150,150-250 and 250～350μg/L. The ratio of the range 50～450μg/L was 91%. There was no significant difference among the four years. Among the 4346 monitoring patients treated with cyclosporine, the number of male was 3047 (70.18%), and female 1296 (29.82%). The ratio of male who reached effective concentration was 92.64%, which was slightly below female (94.21%). There was no significant difference between male and female (p>0.05). Among 5833 patients treated with 5 kind medicine, the number of reaching effective concentration was 4670, whivh ratio was 80.1%, and the number of lower than effective concentration was 1163, which ratio was 19.9%. Conclusion:When phenytoin sodium, carbamazepine, phenobarbital, valproic acid sodium and cyclosporine were used, the dose scheme, medication history, important laboratory data should be analysed comprehensively, and adjusted the dose momentarily according to the blood concentration results and clinical effects, and individualized therapy can be reached. Clinical physician and pharmacist should be stand together to establish a long-term and effective therapeutic schedule using the therapeutic drug monitoring technology to maximumly assure the medicate safe, effective and economical.