丙戊酸钠致7例患者血浆纤维蛋白原降低的初步调查

Preliminary investigation of decreased plasma fibrinogen levels caused by sodium valproate in seven patients

目的:分析口服丙戊酸钠对患者血浆纤维蛋白原含量的影响。方法:收集2007年3月至2008年1月我院收治的使用丙戊酸钠出现血浆纤维蛋白原含量降低患者的临床资料,对患者的性别、年龄、丙戊酸钠的用法用量、用药时间、停药时间、停药前后纤维蛋白原的含量变化及转归进行回顾性调查。结果:7例患者中,男6例,女1例,年龄15～43岁,平均年龄(23.43±9.24)岁,4例口服丙戊酸钠缓释片,3例口服丙戊酸钠片,剂量范围0.1～0.6g,2～3次/d;用药时间为(8.9±8.8)个月;停药时间为(6.14±3.80)d,停药前、后血浆纤维蛋白原含量分别为(1.56±0.45)g/L和(3.98±2.23)g/L,差异有统计学意义(P<0.05)。经停用丙戊酸钠及对症治疗,6例患者纤维蛋白原恢复至2.0g/L,1例停药6d,纤维蛋白原由1.58g/L升至1.71g/L。结论:丙戊酸钠可致患者血浆纤维蛋白原含量降低,用药过程中应监测纤维蛋白原含量,以防引起严重出血。

Objective： To analyse the effects of oral sodium valproate on plasma fibrinogen levels. Methods： Clinical data from the patients with decreased plasma fibrinogen levels in our hospital from March 2007 to January 2008 were collected. The patients＇ sex and age, dosage and administration of sodium valporate, treatment duration, time period after drug withdrawal, changes in fibrinogen levels before and after drug withdrawal, and outcome were investigated retrospectively. Results： Of the 7 patients [ 6 males and 1 female aged 15 - 43 years, average age （23.43 ± 9.24） years ], four received sustained-release sodium valporate tablets and three received sodium valporate tablets. The dosage was 0.1 - 0.6 g two to three times daily. Treatment duration was （8.9 ± 8.8） months. The time period after drug withdrawal was （6.14 ± 3.80） d. Fibrinogen levels before and after drug withdrawal were （ 1.56 ± 0.45 ） g/L and （3.98 ± 2.23 ） g/L, respectively. The difference was stastistically significant （ P 〈 0.05 ）. After stopping sodium valproate and receiving symptomatic therapy, six patients＇ fibrinogen levels increased to 2.0 g/L, One patient＇s fibrinogen level increased from 1.58 g/L to 1.71 g/L 6 days after drug withdrawal. Conclusion： Sodium valproate can decrease plasma fibrinogen levels of patients. Fibrinogen levels should be monitored during sodium valproate therapy for preventing severe bleeding.