【摘要】 目的 研究预防性使用苯妥英钠（phenytoin, PHT）或左乙拉西坦（levetiracetam, LEV）对造血干细胞移植患儿白消安（busulfan, BU）血药浓度的影响。方法 回顾性纳入郴州市第一人民医院2023年9月—2025年2月接受BU+环磷酰胺+氟达拉滨预处理的造血干细胞移植患儿，按预防性抗癫痫方案分为PHT组（24例）与LEV组（26例），比较两组BU血药浓度的差异。结果 BU滴注完0 h时，两组BU血药浓度比较差异无统计学意义（P>0.05）。BU滴注完1 h、2 h、4 h时，LEV组BU血药浓度均高于PHT组（P<0.05）。LEV组BU药时曲线下面积_0～∞(area under the drug concentration time curve from 0 to∞, AUC_0～∞)大于PHT组（P<0.001），且LEV组AUC_0～∞达标率高于PHT组（73%vs 21%,P<0.001）。两组间造血细胞植活时间及BU的药物不良反应发生率比较差异无统计学意义（P>0.05）。结论 相较PHT，使用LEV预防癫痫时，BU的血药浓度和AUC_0～∞达标率更高。暂未发现PHT及LEV对BU的疗效及安全性影响有差异。[中国当代儿科杂志，2025,27（11）:1378-1383]更多还原

【Abstract】 Objective To study the effect of prophylactic phenytoin（PHT） or levetiracetam（LEV） on busulfan（BU） blood concentration in children undergoing hematopoietic stem cell transplantation. Methods Pediatric patients conditioned with BU plus cyclophosphamide and fludarabine at the First People’s Hospital of Chenzhou from September 2023 to February 2025 were retrospectively included. Patients were grouped by prophylactic antiepileptic regimen into PHT（n=24） and LEV（n=26）. BU blood concentrations at the end of infusion（0 hour） and at 1, 2, and 4 hours postinfusion were compared between groups. Results At 0 hour post-infusion, BU blood concentrations did not differ significantly between groups（P>0.05）. At 1, 2, and 4 hours post-infusion, BU blood concentrations were higher in the LEV group than in the PHT group（P<0.05）. The area under the concentration-time curve from 0 to ∞(AUC_0-∞) was greater in the LEV group（P<0.001）, and the attainment rate of AUC_0-∞ was higher in the LEV group than in the PHT group（73% vs 21%, P<0.001）. No significant differences were observed between groups in time to hematopoietic engraftment or in the incidence of BU-related adverse drug reactions（P>0.05）. Conclusions Compared with PHT, LEV prophylaxis is associated with higher BU blood concentration and a higher AUC_0-∞ attainment rate. There is no observed difference in BU efficacy or safety between PHT and LEV. [Chinese Journal of Contemporary Pediatrics, 2025, 27（11）: 1378-1383]更多还原