てんかん患者のバルプロ酸服用量と血清中濃度の関係に及ぼす年齢の影響

Abstract

The relationship between dose and serum concentration of sodium valproate (VPA) was studied in epileptic patients who had received VPA alone chronically. Data of the epileptic patients (in-or out-patients, patient name, age, weight, sex, drug name, dose, serum concentration, dose number per day, sampling time, hepatic and renal function, compliance and seizer control) was putted into a micro-computer as DATA BASE.Blood samples were obtained within one to six hours after the dose in the morning from 203 patients with normal hepatic and renal function, their ages ranged from 0 to 80 years. We divided them into 5 age groups (0≤Y<6, 6≤Y<12, 12≤Y<18, 18≤Y<50, 50≤Y<80 years) from a consideration of different dose (mg/kg/day) to investigate a correlation between dose and serum concentration of VPA in each age group.Regression analysis in these 5 age groups varied greatly. Pediatric groups (0≤Y<12 years) and geriatric group (50≤Y<80years) appeared to have a lower correlation compared to adult groups (12≤Y<50 years).We speculated that this poor correlation was due to interpatient variability, dosage form and foods in the gastrointestinal absorption, poor compliance in pediatric groups, and to lower protein binding in geriatric group.