朱祥路，卢亮，董佑忠，查力
Zhu Xianglu et al(Department of Neurology;

• 1:贵阳医学院神经病学教研室，贵州省老年医学研究所

摘要(Abstract)：

用紫外分光光度法测定了５８例全身性发作或部分性发作的癫痫病人苯妥英的有效血药浓度，并进行了随访观察。结果显示苯妥英的有效血药浓度为９．６６±６．１１ｍｇ／Ｌ。本文讨论了发作类型对苯妥英的有效血药浓度的影响及成人口服苯妥英的起始剂量、有效血药浓度与发作间期脑电图和癫痫复发的关系等问题，并提出了建立稳态警戒值浓度的可行性。
Fifty-eight patients with generalized seizures (GS) or partial seizures (PS) were followed up with determination of the therapeutic concentration for phenytoin (TC-PHT) using ultraviolet Spectrophotometry. Results showed that the TC-PHT was 9.66±6.11mg/L. There was significantly difference in the TC-PHT (P<0.05) when PS was compared with GS. Among 56 patients with steady does during the study, the relapse was correlated with their initial interictal electroencephalogram (IEEG) (P<0.05), but not obviously correlated with their TC-PHT. It is suggested that the steady-state concentration of 15mg/L for PHT is regarded as the warning level of its toxit concentration. Type of seizure and initial IEEG is simultaneously taken for the referential index to monitor the TC-PHT.

关键词(KeyWords)： 苯妥英，癫痫，有效血药浓度，稳态警戒值
phenytoin; epilepsy; therapeutic concentration; steady-state warning level

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 朱祥路，卢亮，董佑忠，查力
Zhu Xianglu et al(Department of Neurology;

DOI: 10.19367/j.cnki.1000-2707.1994.02.022

参考文献(References)：

• 1WooE，etal．Ifawell－stabilizedepilepticpatienthassubtherapeuticantiepilepticdruglevel，shouldthedosebeincreased？Arandomizedprospectivestudy．Epilepsia，1988，29（2）：1292SchmidtD，etal．Therapeuticplasmalevelsofphenytoin，phenobarbital，andcarbamazepine：individualvariationinrelationtoseizurefrequencyandtype．Neurology，1984，34（9）；12523WilliamH，etal．Phenytoin：thepseudosteady－statephenomenon．ClinPharmacol＆Therapeutics，1984，35：8224WeltyTE，etal．Acomparisonofphenytoindosingmethodsinprivatepracticeseizurepatients．Epilepsia，1986，27（1）：765SchmidtD，etal．Theinfluenceofseizuretypeontheefficacyofplasma．concentrationsofphenytoin，phenobarbital，andcarbamazepine．ArchNeurol，1986，43（3）：2636TurnbullDM，etal．Therapeuticserumconcentrationofphenytoin：theinfluenceofseizuretype．JNeurolNeurosurgPsychiatr，1984，47：2317EslavaCobosJ．High－dosephenytoininthetreatmentofrefractoryepilepsy．Epilepsia，1987，28（2）：1118DuncanJS．Antiepilepticdrugsandtheelectroencephalogram．Epilepsia，1987，28（3）：2599EmersonR，etal．Stoppingmedicationinchildrenwithepilepsy：predictorsofoutcome．NEnglJmed，1981，304：1125

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