Carbamazepine Blood Drug Concentration Monitoring And Evaluation Of Treatment Efficacy For Children With Epilepsy

Objective: The present study reported that carbamazepine treatment of epilepsy has individual differences and narrow therapeutic range.This study based on establishing a high performance liquid chromatography(HPLC)method to detect blood drug concentration of carbamazepine(CBZ)after Epilepsy children taking carbamazepine.By analysizing the correlation between blood drug concentration of carbamazepine and clinical curative effect through observing test results so as to determine its effect on the treatment of pediatric epilepsy.By exploring carbamazepine adverse reactions related to the differences caused by different blood drug concentration so as to provide theoretical basis for pediatric epilepsy individualized treatment and provide reference for clinical rational drug use and help.Method: Choosing 312 children treated with epilepsy from April 2011 to April 2015 in Jiangxi Province Children Hospital as the research object.Among them,236 children took in carbamazepine alone,76 children received other drugs.The average age of them was(6.2±1.2)years,average weight was(27.4±2.1)kg,average duration of disease was(2.1±0.3)years.The plasma concentrations of carbamazepine were measured by HPLC.The serum concentration of carbamazepine was determined by the concentration of carbamazepine in four different concentration ranges: <4.0?g/ml group,4.0 8.0?g/ml group,8.0-12.0?g/ml group and >12.0?g/ml group.The plasma concentration range of each group was recorded and the total effective rate and adverse reaction rate were calculated.Results: All pediatric epilepsy taking in carbamazepine successful completed correct monitoring of plasma concentration.The total number of patients in each group and the total effective rate were: <4?g/ml in 28 cases,the total effective rate was 32.14%;4.0-8.0?g/ml in 135 cases,the total effective rate was 79.26%;8.0-12.0?g/ml in 134 cases,the total effective rate was 82.08%;>12.0?g/ml in 35 cases,total effective rate was 31.43%.The results shown that the total effective rate of children was obviously higher in the 4.0-8.0?g/ml,8.0-12.0?g/ml group than that of other groups,and the difference was statistically significant(P<0.05).But its total efficiency is not with the concentration of plasma concentration-dependent increase,the incidence of adverse reactions increased when Blood drug concentration is too high.Blood concentration between 4.0-8.0?g/ml,whose total effective rate is 79.26% and low incidence of adverse events is 11.85%,are the ideal blood concentration range of carbamazepine.Conclusion: Regular monitoring blood drug concentration in epilepsy children treated with carbamazepine,to control the blood concentration of carbamazepine in a appropriate range(4.0-8.0?g/ml),can get a higher therapeutic effect and obtain lower incidence of adverse reactions at the same time.