不同年龄和剂量组癫痫患儿服用丙戊酸钠后的肝功能变化(1)
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[摘要] 目的:观察服用丙戊酸钠(VPA)的癫痫患儿肝功能的变化,并对其影响因素进行分析,初步了解:①患儿服用VPA后肝功能指标的变化及其特征;②分析患儿服用VPA后肝功能变化的影响因素,指导在临床工作中合理用药,减少副作用。方法: 54例服用不同剂量及不同年龄的癫痫患儿,分别比较服药前和服药3个月后的ALT、AST和γ-GGT水平。结果:VPA在服用早期即可以明显升高肝酶,其中以ALT、AST为著,肝酶指标的变化与患儿年龄和VPA剂量有关,年龄因素和剂量因素存在相互作用,随着年龄的增大,剂量对于肝酶指标变化的影响逐渐减小。剂量对于肝酶指标变化的影响突出表现在小年龄组患儿,随着VPA剂量的加大,肝酶指标的变化也增加。结论:肝酶的严重升高仅见于小年龄组服用大剂量的患儿,对于小年龄患儿,要避免应用大剂量VPA。
[关键词] 癫痫;丙戊酸钠;肝功能;儿童
[中图分类号] R742.1[文献标识码]A [文章编号]1673-7210(2009)08(a)-020-03
The change of liver function in epileptic children of different ages and doses after administering Sodium Valproate
WANG Yanli, LI Gang, SHEN Jinyun
(The Third Affiliated Hospital of Guangzhou Medical College, Guangzhou 510150, China)
[Abstract] Objective: To observe the change of liver function in epileptic children administering Sodium Valproate (VPA), and analyze the influencing factors, and further understand: ①the change and characteristics of liver function of children administering VPA; ②analysis with the children administering VPA after the impact of changes in liver function factors, to guide clinical work in the rational use of drugs to reduce side effects. Methods: The ALT, AST and γ-GGT levels from 54 children with espilepsy were measured before and 3 months after VPA therapy. Results: The use of VPA at an early stage could significantly increase liver enzymes, especially ALT and AST. The liver enzyme changes were related to the age and dose of VPA of children, the age of children showed correlation with the dose, the effect of dose on liver enzyme changes was gradually decreased with the increase of age. The effect of dose on liver enzyme changes was obvious in small age group, the liver enzyme changes was increased with the increase of dose of VPA. Conclusion: Significant increase of liver enzymes is only found in administering a large dose of children of small age group, thus it is necessary to avoid large dose of VPA for small age children.
[Key words] Epilepsy; Sodium Valproate; Liver function; Children
癫痫是小儿常见的神经系统疾病,其发病率为0.4%~0.6%[1-2],其治疗依靠长期服用抗癫痫药物 ......
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