本文選題：癲癇 + 數(shù)據(jù)庫��； 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：目的 通過建立癲癇數(shù)據(jù)庫,從中提取應(yīng)用奧卡西平治療的成人癲癇患者信息,觀察及評(píng)價(jià)奧卡西平(Oxcarbazepine, OXC)在成人癲癇患者的治療過程中,其活性代謝物10,11-二氫-10-基卡馬西平(monhydroxycarbazepin, MHD)血藥濃度與臨床療效及安全性的相關(guān)性,為臨床工作中奧卡西平的合理應(yīng)用提供依據(jù)。同時(shí)提高癲癇數(shù)據(jù)庫整理管理經(jīng)驗(yàn),便于癲癇患者的長程管理治療。 方法 收集2013年02月至2014年02月,蘇州大學(xué)附屬第二醫(yī)院門診及病房收治的確診為癲癇的成人患者,同時(shí)將其錄入成人癲癇數(shù)據(jù)庫,詳細(xì)記錄患者姓名、年齡、身高、體重和聯(lián)系方式等基本資料,以及用藥種類、劑量,聯(lián)合用藥,藥物相關(guān)不良反應(yīng)等詳細(xì)信息。從中提取接受奧卡西平治療患者的數(shù)據(jù)資料,同時(shí)建立高效液相色譜法測(cè)定MHD穩(wěn)態(tài)血藥濃度,并隨訪其服藥后相關(guān)不良反應(yīng)及三個(gè)月后的臨床療效。分析血藥濃度與給藥劑量(藥物劑量/重)之間的關(guān)系,探討奧卡西平血藥濃度與臨床療效的關(guān)系。 結(jié)果 癲癇數(shù)據(jù)庫共收錄了92例癲癇患者,提取其中接受奧卡西平治療的的患者42例,其中男性28例、女性14例；年齡16～77歲,平均年齡(37.2±17.9)歲；身高(169.0±6.7)cm,體重(65.7士11.6)kg,BMI(23.0±3.5)。治療總有效率為76.47%,血藥濃度位于有效治療窗內(nèi)組的療效為91.3%,低于有效治療窗組為64.2%,經(jīng)x2檢驗(yàn),有效治療窗內(nèi)組的療效優(yōu)于低于有效治療窗組(P0.05)；給藥劑量(藥物劑量／體重)與血藥濃度呈正相關(guān),為一元一次線性回歸關(guān)系,方程為C=0.275×D+6.86(R=0.402,P=0.03)。治療組內(nèi)共8例出現(xiàn)不良反應(yīng),發(fā)生率為19.0%,不良反應(yīng)發(fā)生率低,且程度較輕。 結(jié)論 癲癇數(shù)據(jù)庫的建立,有利于臨床醫(yī)師制定及實(shí)施個(gè)體化、規(guī)范化的抗癲癇治療方案,提高藥物保留率及治療療效。奧卡西平治療癲癇療效顯著,不良反應(yīng)發(fā)生率低,通過血藥濃度檢測(cè),可有助于臨床醫(yī)生個(gè)體化給藥,對(duì)于臨床癲癇癥狀的控制有良好的指導(dǎo)作用。
[Abstract]:Purpose Through the establishment of epilepsy database, the information of adult epileptic patients treated with oxcarbazepine (Oxcarbazepine) was extracted, and the course of treatment of adult epilepsy patients was observed and evaluated. The correlation between the serum concentration of MHDand the clinical efficacy and safety of its active metabolite 101- dihydro-10-dihydrocarbazepin (MHD) provides a basis for the rational use of oxcarbazepine in clinical work. At the same time, we can improve the management experience of epilepsy database, and facilitate the long-range management treatment of epilepsy patients. Method From February 2013 to February 2014, adult patients who were diagnosed with epilepsy in outpatient and ward of the second affiliated Hospital of Suzhou University were collected and recorded in the adult epilepsy database, and the names, ages, height of the patients were recorded in detail. Basic information such as body weight and contact information, as well as drug use, dosage, combination, drug-related adverse reactions and other details. The data of patients treated with oxcarbazepine were extracted, and the steady-state blood concentration of MHD was determined by HPLC, and the related adverse reactions were followed up and the clinical effect after 3 months was followed up. The relationship between serum concentration and dosage (dosage / weight) was analyzed, and the relationship between serum concentration of oxcarbazepine and clinical efficacy was discussed. Result A total of 92 epileptic patients were included in the Epilepsy Database, 42 of whom were treated with oxcarbazepine, including 28 males and 14 females, aged 1677 years with an average age of 37.2 鹵17.9 years, with a height of 169.0 鹵6.7 cm and a body weight of 65.7 鹵11.6 kg / kg BMI23.0 鹵3.5%. The total effective rate of treatment was 76.47. The effect of blood drug concentration in the effective treatment window group was 91.3, which was lower than that in the effective treatment window group (64.22.x2 test). The effective therapeutic effect in the intrawindow group was better than that in the effective window group, and the dose (drug dose / body weight) was positively correlated with the concentration of the drug in the blood, which was a linear regression equation with a equation of 0.275 脳 D 6.86RX 0.402Pu 0.03ng.The effect was better than that in the effective window group (P 0.05), and the dose of the drug (dosage / body weight) was positively correlated with the concentration of the drug in the blood. In the treatment group, there were 8 cases of adverse reactions, the incidence rate was 19.0, the incidence of adverse reactions was low and the degree was mild. Conclusion The establishment of epilepsy database is helpful for clinicians to formulate and implement individualized antiepileptic therapy and to improve drug retention rate and therapeutic effect. The efficacy of oxcarbazepine in the treatment of epilepsy is significant and the incidence of adverse reactions is low. The detection of serum concentration of oxcarbazepine can be helpful to the individual administration of the drug by clinicians and has a good guiding effect on the control of clinical epileptic symptoms.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R742.1
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本文編號(hào)：1969301