癫痫患儿丙戊酸钠使用致药物性肝功能变化的相关性研究  

Correlative study on the changes in liver function caused by sodium valproate in children with epilepsy

作　　者：翁爱彬[1] 翚小愉 林清双 WENGAibin;HUI Xiaoyu;LIN Qingshuang(Department of Clinical Pharmacology,the Affiliated Hospital(Group)of Putian University,Putian 351100,China;Pharmaceutical and Medical Technology College of Putian University,Putian 351100,China)

机构地区：[1]莆田学院附属医院药剂科,莆田351100 [2]莆田学院药学与医学技术学院,莆田351100

出　　处：《癫痫杂志》2022年第2期123-126,共4页Journal of Epilepsy

基　　金：福建莆田市科技局资助项目(2018S3F013)。

摘　　要：目的 研究莆田地区癫痫患儿在长期使用丙戊酸钠(Sodium valproate,VPA)治疗过程肝功能变化等的相关性,探讨临床用药过程中进行个体化给药进而提升临床患儿用药依从性的方法及依据。方法 回顾性分析350例于2018年6月1日—2021年3月1日期间在莆田学院附属医院单用丙戊酸钠治疗的0~14岁癫痫患儿的丙戊酸钠血药浓度及相关生化检测的数据,按照VPA血药浓度结果分为低血药浓度组(<50μg/mL)、治疗血药浓度组(50~100μg/mL)和高血药浓度组(>100μg/mL)。随机抽取350名同期在我院健康查体的0~14岁儿童的生化常规作为对照组。结果 (1) VPA治疗组与对照组肝功能指标均无统计学差异(P>0.05);(2)各VPA血药浓度范围组间肝功能谷丙转氨酶、谷草转氨酶、谷草转氨酶/谷丙转氨酶、总胆红素和直接胆红素存在统计学差异(P<0.05);(3)高浓度血药浓度的肝功能指标异常发生率较低浓度、治疗浓度组高,且存在差异(P<0.05)。结论肝功能异常在高血药浓度治疗组中较常见,应及时调整患儿用药剂量以避免药导致的肝损伤。Objective To study the correlation of changes in liver function during long-term treatment with sodium valproate(VPA) in children with epilepsy in Putian,and to explore individualized administration to improve the compliance of children with medication.Methods The blood concentration of VPA and related biochemical test data of350 children with epilepsy from June 1,2018 to March 1,2021 were collected in our hospital.According to the results of VPA blood concentration,they were classified as low Blood concentration group(<50 μg/mL),therapeutic blood concentration group(50 ~ 100 μg/mL) and high blood concentration group(>100 μg/mL).Results(1) There was no significant difference in liver function indexes between the VPA treatment group and the control group(P>0.05).(2)There were significant differences in liver function ALT,AST,AST/ALT,TBIL and DBIL among the groups of VPA blood concentration range(P<0.05).(3) The abnormal incidence of liver function indexes of high blood drug concentration was lower in the concentration group and higher in the treatment concentration group,and there were differences(P<0.05).Conclusion Abnormal liver function in the high blood drug concentration treatment groupis quite common,and the dose of the drug should be adjusted in time to avoid liver damage caused by the VPA.

关 键 词：丙戊酸钠 肝功能异常 血药浓度 癫痫 

分 类 号：R742.1[医药卫生—神经病学与精神病学]