丙戊酸钠对不同发作类型癫痫患者白细胞毒性的临床检验学特征  

Sodium valproate in clinical examination for different leukocyte toxicity in patients with the type of seizure characteristics

作　　者：张敬军[1] 陈青[2] 

机构地区：[1]泰山医学院附属医院神经内科,泰安271000 [2]泰山护理职业学院

出　　处：《中华诊断学电子杂志》2014年第1期41-43,共3页Chinese Journal of Diagnostics(Electronic Edition)

基　　金：山东省自然科学基金(ZR2011HL008);山东省卫生厅课题(2011HD017)

摘　　要：目的探讨丙戊酸钠(VPA)对不同发作类型癫痫患者白细胞毒性的临床检验学特征,分析丙戊酸钠致血液系统毒性发生的一般规律及特点,初步探讨其可能的发生机制。方法对61例明确诊断癫痫患者,使用丙戊酸钠单药治疗,空腹采取中指外周血,立即送检,用SYSMEX血细胞自动分析仪测其外周血象包括红细胞、血红蛋白、白细胞、血小板数目。应用SPSS 13.0统计学软件进行数据处理,治疗前后白细胞计数比较采用t检验。结果 61例癫痫患者,服用丙戊酸钠治疗后,其中55例患者白细胞数量降低,3例患者红细胞数量降低,10例患者血小板降低,丙戊酸钠致血液毒性反应复杂多样。不同发作类型癫痫VPA治疗后,白细胞计数均降低[如全身强直阵挛发作:治疗前(5861.03±979.39)109/L,治疗后(3455.17±283.58)109/L;单纯部分发作治疗前(5587.50±859.30)109/L,治疗后(3512.50±279.99)109/L,差异有统计学意义(t=14.88,7.388;P<0.05)]。而VPA治疗不同发作类型癫痫前后,各类型间白细胞差异无统计学意义。结论丙戊酸钠可导致部分癫痫患者白细胞、红细胞及血小板水平降低,白细胞数量减少与发作类型无关。Objective To investigate the clinical tests of white blood cell of different types of epilepsy patients who treated with valproate,to analyse the rules and characteristics of hematological toxicity,and to explore its possible mechanism.Methods Sixty-one patients with epilepsy,taken fasting peripheral blood immediately after the use of valproate monotherapy,and peripheral hemogram measurement was detected by SYSMEX automatic blood cell analyzer,including red blood cell,hemoglobin,white blood cell,platelet count. Results There were various manifestations of hematological toxicity of sixty-one patients with epilepsy,The number of white blood cell in fifty-five patients decreased among them,the number of red blood cell in three patients decreased,and the platelet count decreased significantly in ten patients.After being treated with sodium valproate.After using valproate treatment,white blood cell count reduced in all types,the differences were statistically significant.But there was no statistical difference among the types of white blood cell. Conclusions Sodium valproate can cause leucocyte count,red blood cell count and platelet levels decrease in some patients with partial epilepsy and the decrease of white blood cells count has nothing to do with different types of eplepsy.

关 键 词：癫痫 丙戊酸 白细胞 

分 类 号：R742.1[医药卫生—神经病学与精神病学]