丙戊酸钠致血小板减少性紫癜8例临床分析

Clinical analysis of thrombocytopenic purpura caused by sodium valproate treatment in 8 children with epilepsy

目的 探讨丙戊酸钠致血小板减少性紫癜可能发生机制。方法 对 8例患儿服用丙戊酸钠在 (3～ 5 .5 )个月内相继全身出现紫癜样皮诊进行血小板计数 ,出血时间和药物血浓度监测。结果 服用丙戊酸钠 3～ 5 .5个月全身出现紫癜样皮疹患儿血小板计数明显降低 ,出血时间延长 ,根据本组临床资料显示 ,血小板减少数量与丙戊酸纳药物血浓度正相关。结论 丙戊酸钠能影响患儿的血小板计数和功能。导致血小板计数降低 ,出血时间延长 ,患儿以双下肢为主、全身皮肤出现紫癜样皮疹 ,其中 2例并伴有牙龈出血 。

OBJECTIVE To explore the pathogenesis of thrombocytopenic purpura caused by sodium valproate treatment. METHOD Platelet counts ,bleeding times and blood levels of sodium valproate of 8 cases of children with epilepsy who presented purpura 3～5.5 months after Sodium valproate treatment were measured. RESULTS All patients presents purpura over the whole body skin, especially over two legs skin, and 2 cases of those patients presented gingival bleeding. All patients showed decreased platelet counts and prolonged bleeding times, and the decrements of platelet counts positively related with the blood levels of sodium valproate.CONCLUSION Treatment with sodium valproate may influence the count and function of platelets in children with epilepsy, the extent of which may correlate with the dosage of sodium valproate .