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丙戊酸钠(VPA)作为一种抗癫癎药,由于比较安全,少有严重的付作用,在临床使用越来越广泛.然而,1974年Jesdinsky-Buscher在服用VPA的病人发现凝血机能障碍,此后几篇报告均提到服用VPA出现出血倾向、血小板减少症和血小板机能障碍.本文重点复习这些付作用的实际发生率和临床意义.病例情况如下:1.自发性紫癜、血肿、出血18例;2.出血时间延长伴有或不伴出血倾向4例;3.血小板减少伴出血,一般均无临床后果23例;4.血小板机能异常如血小板粘附或聚集障碍11例;5.凝血因子改变13例;6.血浆纤维旦白原下降5例;7.血清抗血小板抗体1例.系统调查:1975 Stolzis等对83例服用VPA患者进行328次血小板计数,在两年期间,14例血小板计数降低,在VPA剂量不变情况下,10人有1～2次,
VPA, as an antiepileptic drug, is becoming more and more widely used clinically due to its safety and few serious side effects.However, in 2007, Jesdinsky-Buscher found coagulation dysfunction in patients taking VPA , Since several reports have mentioned the tendency of bleeding, thrombocytopenia and platelet dysfunction in VPA.This article focuses on the review of the actual incidence of these effects and clinical significance.The cases are as follows: 1. Spontaneous purpura, hematoma, hemorrhage 18 Cases; 2 bleeding time with or without bleeding tendency in 4 cases; 3. thrombocytopenia with bleeding, generally no clinical consequences in 23 cases; 4. platelet dysfunction such as platelet adhesion or aggregation disorders in 11 cases; 5. clotting Factor changes in 13 cases; 6 plasma fibedes decreased in 5 cases; 7 serum anti-platelet antibody in 1. Systematic survey: 1975 Stolzis so on 83 patients taking VPA 328 platelet count, in two years, 14 cases Platelet count decreased in the same dose of VPA cases, 10 people have 1 or 2 times,