论文部分内容阅读
目的:回顾分析老年患者丙戊酸脑病的临床及实验室检查特点,提高对丙戊酸脑病的认识及诊断水平。方法:收集我院神经内科2010年1月~2014年12月应用丙戊酸钠(VPA)后确诊为丙戊酸脑病患者4例,比较其临床表现及实验室检查的特点。结果:4例患者中男3例,女1例,平均年龄(70.3±9.8)岁;均为单用VPA;表现为意识障碍、认知功能下降;肝功能及丙戊酸钠血药浓度均在正常范围,血氨浓度升高;脑电图提示广泛漫波增多,以θ和δ波占优;4例患者停用VPA 2周后症状改善,血氨浓度下降。结论:丙戊酸脑病突出临床表现为意识障碍、认知功能下降,临床使用VPA时应予以高度重视。及时停药后症状可逐缓解,其愈后良好。
OBJECTIVE: To retrospectively analyze the clinical and laboratory features of valproic acid encephalopathy in the elderly and to improve the understanding and diagnosis of valproic acid encephalopathy. Methods: Four cases of valproic acid encephalopathy confirmed by VPA were collected from January 2010 to December 2014 in our hospital. The clinical manifestations and the characteristics of laboratory tests were compared. Results: Among the 4 patients, there were 3 males and 1 females, with an average age of (70.3 ± 9.8) years. All of them were VPA alone. They showed disturbance of consciousness and decreased cognitive function. Both liver function and plasma sodium valproate In the normal range, blood ammonia concentration increased; EEG showed a wide range of increased diffuse waves, θ and δ waves dominated; 4 patients with VPA withdrawal of symptoms after 2 weeks to improve the blood ammonia concentration decreased. Conclusions: Valproic acid encephalopathy is characterized by disturbance of consciousness and impaired cognitive function, and should be given high priority in the clinical use of VPA. Symptoms can be relieved promptly after stopping, the prognosis is good.