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1974年Sutor等注意到在服用丙戊酸钠(VPA)的病人中有凝血障碍.迄今的个案报导有自发性血肿、紫斑或出血18例,出血时间延长4例,血小板减少伴出血但无临床不良后果者23例,血小板功能障碍11例,凝血因子异常13例,纤维旦白元浓度降低5例.有几组系统调查服VPA的病人共1,220名,结果相当矛盾:有3组共233例未见血液学障碍;另一组23例的凝血弹性描记均异常.作者在讨论中提出应注意以下几点:①使用VPA引起的血液学变化主要是血小板功能障碍或血小板减少.②根据使用VPA前后的血液学参数测定,肯定VPA要对血小板减少及血小板功能障碍负责.③血液学改变可在用药后早期发生,也可在几年后出现,后者常在偶然的机会如手术或感染情况下出现临床症状,并多为儿童患者使用大剂量VFA所引起.合理的剂量不超过每日40mg/kg.④VPA引起血
In 1974, Sutor et al noted that there were coagulopathy in patients taking VPA, 18 cases of spontaneous hematoma, purpura or hemorrhage, 4 cases of prolonged bleeding, 4 cases of thrombocytopenia and no clinical bleeding 23 cases of adverse consequences, 11 cases of platelet dysfunction, abnormal coagulation factor in 13 cases, fibdecone concentration decreased in 5. There are several groups of patients surveyed with VPA total of 1,220 patients, the results quite contradictory: a total of 233 cases in 3 groups No hematological disorders were found in the other group.Another group of 23 patients had abnormal thromboelastography.The authors raised the following points during the discussion: ①Hematological changes caused by VPA were mainly platelet dysfunction or thrombocytopenia.②According to the use of VPA Hematological parameters before and after the determination of VPA to be sure to be responsible for thrombocytopenia and platelet dysfunction.③Heological changes can occur early after treatment, but also in a few years after the latter often by chance, such as surgery or infection Under clinical symptoms, and more for children with high doses of VFA caused by a reasonable dose does not exceed 40mg / kg daily .VPA caused by blood