中国临床药学杂志

目的 探讨荧光免疫层析法在丙戊酸钠血药浓度监测中的应用，并深入分析丙戊酸钠血药浓度的影响因素。方法 收集2023年7月1日至2024年10月30日使用丙戊酸钠并接受血药浓度(采用荧光免疫层析法测定)监测的146例患者的临床资料，包括年龄、性别、药物剂型、给药剂量及合并用药等信息。将丙戊酸钠血药浓度在50～100μg·mL^-1内判定为达标，采用SPSSPRO软件对丙戊酸钠血药浓度的影响因素进行多因素方差分析。结果 丙戊酸钠血药浓度达标率为51.37%。丙戊酸钠血药浓度与患者的年龄和性别均无显著相关性，而与药物剂型、给药剂量及合并用药情况相关(P<0.05)。当丙戊酸钠血药浓度> 100μg·mL^-1时，不良反应发生率为57.14%。结论 对使用丙戊酸钠治疗的患者建议开展常规血药浓度监测，并基于结果制订个体化给药方案，以优化疗效、降低不良反应风险。

AIM To explore the application of fluorescent immunochromatographic assay in monitoring plasma concentration of sodium valproate(VPA), and conduct an in-depth analysis of the relevant factors affecting VPA plasma concentration. METHODS Clinical data of 146 patients who received VPA and underwent plasma concentration monitoring(measured by fluorescence immunochromatography assay) from July 1, 2023 to October 30, 2024 were collected, including information such as age, gender, drug dosage form, administration dosage, and concomitant medications. The steady-state plasma concentration of VPA within the range of 50-100 μg·mL^-1 was defined as reaching the target. SPSSPRO software was used to perform multivariate analysis of variance on the factors affecting the VPA plasma concentration. RESULTS The compliance rate of VPA plasma concentration was 51.37%. The VPA plasma concentration had no significant correlation with patients' age or gender; however, it was correlated with drug dosage form, administration dosage, and concomitant medications(P < 0.05). When the VPA plasma concentration exceeded 100 μg·mL^-1, the incidence of adverse reactions was 57.14%. CONCLUSION It is recommended that patients receiving VPA therapy undergo routine therapeutic drug monitoring, with individualized dosing regimens formulated based on results to optimize efficacy and reduce the risk of adverse reactions.