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目的研究丙戊酸(VPA)治疗对癫癎患儿血浆氨水平的影响。方法测定2003-04—2004-02在山东大学齐鲁医院儿科癫癎治疗中心就诊且服用VPA的32例癫癎患儿和33例与之年龄匹配的对照儿(儿外科患儿)的血浆氨和游离肉毒碱的浓度,并测定32例癫癎患儿的VPA的血药质量浓度。对服用VPA的癫癎患儿血氨与VPA的剂量、质量浓度、肉毒碱浓度进行相关分析。结果VPA治疗组血氨浓度高于对照组,差异具显著性意义。血氨与VPA剂量、VPA血药质量浓度显著正相关;与游离肉毒碱浓度相关性无统计学意义。联合用药组血氨浓度高于单一用药组。结论VPA治疗可引起血氨浓度增加,且血氨与VPA剂量、VPA血药质量浓度显著正相关,与游离肉毒碱浓度相关性无统计学意义,联合用药可能是血氨增高的危险因素。
Objective To investigate the effect of valproic acid (VPA) treatment on plasma ammonia level in children with epilepsy. Methods 2003-04-2004-02 32 patients with epilepsy and 33 age-matched control children (pediatric surgical pediatric patients) were enrolled in pediatric epilepsy treatment center of Qilu Hospital of Shandong University. Plasma ammonia and Free carnitine concentration, and determination of 32 cases of epilepsy in children VPA plasma concentration. The dose, mass concentration and carnitine concentration of blood ammonia and VPA in epileptic children taking VPA were analyzed. Results The serum ammonia concentration of VPA treatment group was higher than that of control group, the difference was significant. Blood ammonia and VPA dose, VPA plasma concentration of mass concentration was significantly correlated; and free carnitine concentration correlation was not statistically significant. The concentration of ammonia in combination group was higher than that in single group. Conclusions VPA treatment can cause increase of blood ammonia concentration, and there is a significant positive correlation between blood ammonia and VPA dose and VPA blood mass concentration. There is no significant correlation with free carnitine concentration. Combination therapy may be a risk factor of blood ammonia increase.