丙戊酸致高氨血症的影响因素研究进展

Research progress on influencing factors of hyperammonemia caused by valproic acid

丙戊酸(valproic acid,VPA)是一线广谱抗癫痫药物,临床应用广泛,相关研究及临床实践显示VPA可导致患者出现高氨血症,VPA相关高血氨症在临床上易与患者自身疾病临床症状相似而难以早期预警,目前研究发现年龄、血药浓度、合并用药以及遗传等因素可导致VPA相关性高血氨。本文从VPA诱发血氨升高的机制出发,分析国内外有关VPA相关高氨血症的危险因素、治疗及生物标志物的研究,为VPA临床安全、有效、个体化用药提供参考。

Valproic acid(VPA)is a first-line broad-spectrum antiepileptic drug with wide clinical application.Related studies and clinical practice have shown that VPA can lead to hyperammonemia in patients.VPA-related hyperammonia is easy to be similar to the clinical symptoms of patients’own diseases,so it is difficult to early warning.Current studies have found that age,blood concentration,combined use of drugs and genetic factors can lead to VPA-related hyperammonia.Based on the mechanism of elevated blood ammonia induced by VPA,this article analyzes the risk factors,treatment and biomarkers of VPA-related hyperammonemia at home and abroad,so as to provide reference for the safe,effective and individual use of VPA.