某院丙戊酸血药浓度监测结果及警戒值的设置探讨

Objective To analyze and discuss the monitoring results of blood concentration of valproic acid and the setting of warning value, so as to promote the safe and rational use of valproic acid. Methods Collect the blood concentration monitoring data of valproic acid in Lishui Second People's Hospital from January to December 2024, as well as the relevant medical records of patients whose blood concentration exceeded the warning value. The records include test results, patient visit types, gender and other information. Use SPSS 26.0 to conduct statistical analysis on the relevant data. Results Among the 2,412 instances of valproic acid concentration monitoring, the valproic acid concentration in females was higher than that in males(P<0.05). The concentration of valproic acid in patients of different age groups showed a decreasing trend with increasing age(P<0.05). There were significant differences in the proportions of patients of different visiting types, genders, and age groups whose valproic acid blood concentration was below the therapeutic window, within the therapeutic window, or above the therapeutic window(P<0.05). Among the 93 alert values, 32 cases of adverse drug reactions occurred, accounting for 34.4%. The adverse reactions mainly affected the nervous system and digestive system. The alert value for the occurrence of adverse reactions was 140.27(127.54, 153.77) μg/mL, while the alert value without any adverse reactions was 128.08(124.62, 137.07) μg/mL(P=0.002). There were 36 cases with relevant clinical interventions for the warning values, while 57 cases did not have any such interventions. The warning value for valproic acid with clinical intervention was 142.54(132.36, 155.15) μg/m L, and the warning value without clinical intervention was 126.58(124.16, 134.48) μg/mL(P<0.001). Conclusion The influence of gender and age should be considered when using valproic acid in clinical practice. It is necessary to strengthen the advice and education of correct medication for outpatients and their families. The valproic acid alert value recommended by the association of neuropsychopharmacology and pharmacopsychiatry(AGNP) may be set slightly lower in practical application, and more research is needed to verify.