期刊文献+

丙戊酸钠致高氨血症脑病性意识障碍(附5例报告) 被引量:19

在线阅读 下载PDF
导出
摘要 目的报告神经外科患者使用丙戊酸钠(sodium valproate,VPA)预防癫痫致高氨血症脑病(hyperammonemia encepha-lopathy,VHE)性意识障碍的临床表现、治疗。方法回顾性分析我科丙戊酸钠致VHE出现意识障碍5例患者的临床资料,分析VHE性意识障碍患者的肝功能、血氨浓度、药物浓度、脑电图等特征性变化。结果本组患者出现专科难以解释的急性亚急性意识障碍,血氨浓度升高,丙戊酸药物浓度及肝功能均在正常范围之内,脑电图广泛慢波增多、δ波θ波活跃、出现三相波,予以停用丙戊酸钠,同时予以精氨酸降血氨处理,血氨浓度下降,患者意识同时出现好转。结论临床使用丙戊酸钠期间,应定期复查丙戊酸药物浓度、血氨浓度、肝功能,脑电图出现特征性变化时,要高度重视高氨血症脑病性意识障碍的存在,以免耽误病情,造成不必要的损害。
出处 《中国神经精神疾病杂志》 CAS CSCD 北大核心 2011年第7期430-432,共3页 Chinese Journal of Nervous and Mental Diseases
作者简介 通讯作符(E-mail:shqh69@yahoo.com.cn)
  • 相关文献

参考文献14

  • 1Wadzinski R, Franks D, Roane D, et al. Valproate associated hy- perammonemic encephalopathy [ J ]. Board of Family Medicine, 2007,20 (5) :499 - 502.
  • 2Feil D, Chuang K, Sultzer DL. Valproate-induced hyperammonemia as a cause of altered mental statul[ J]. Geriatic Psychiatry,2002,10 (4) :476 -478.
  • 3Segura-BrunaN, Rodriguez A, Puente V. Valproate induced hy- perammonemic encephalopathy[J]. Acta Neurol Scand, 2006,114 (1):1 -7.
  • 4全国神经外科癫痫防治协助组,周良辅,郑康,卢亦成,王硕,刘伟国,张祖勇,史继新,李昭杰,徐如祥,漆松涛,章翔,杨卫忠.神经外科围手术期和外伤后癫痫的预防及治疗指南(草案)[J].中华神经医学杂志,2006,5(12):1189-1190. 被引量:55
  • 5Mittal V,Mumalee S, Tampi RR. Valproic acid-Induced hyperammonemia in the elderly:A review of the literature[ J]. Case Reports Med,2009,10(1 ) :1 -5.
  • 6陈佳,刘凤君,吴逊.丙戊酸治疗成人癫致血浆肉毒碱下降[J].中国神经精神疾病杂志,2007,33(11):669-671. 被引量:6
  • 7Hawkes ND, Thomas GAO, Jurewicz A, et al. Non-hepatic hy- perammonaemia: an important, potentially reversible cause of encephalopathy[J]. Postgraduate Medical Journal, 2001,77 (913) : 717 - 722.
  • 8Vossler DG,Wilensky AJ,Cawthon DF, et al. Serum and CSF glutamine levels in valproate-related hyperammonemic encephalopathy [J]. Epilepsia,2002, 43(2) :154 - 159.
  • 9McCall M, Bourgeois JA. Valproic acid-induced hyperammonemia: a case report [ J ]. Clinical Psy-chopharmacology, 2004,24 (5) : 521 - 526.
  • 10Yagi M,Nakamura T, Okizuka Y, et al. Effect of CPS14217C > A genotype on valproic-acid-induced hyperammonenfia[ J]. Pediatrics International,2010, 52(12) :744 -748.

二级参考文献14

  • 1李朝霞,孙若鹏,刘心洁,郭淑华.丙戊酸对癫患儿血浆肉毒碱浓度的影响[J].中国实用儿科杂志,2005,20(10):626-627. 被引量:3
  • 2Bohan TP, Helton E, McDonald I, et al. Effect of L-earnitine treatment for valproate-induced hepatotoxicity. Neurology, 2001, 56 (10) : 1405.
  • 3Prieto JA, Andrade F, Aldamiz-Echevarria L, et al. Determination of free and total carnitine in plasma by an enzymatic reaction and spectrophotometric quantitation spectrophotometric determination of carnitine. Clin Biochem, 2006, 39(10) : 1022.
  • 4Hiraoka A, Arato T, Tominaga I. Reduction in blood free carnitine levels in association with changes in sodium valproate ( VPA ) disposition in epileptic patients treated with VPA and other anti-epileptic drugs. Biol Pharm Bull, 1997, 20(1) : 91.
  • 5Castro-Gago M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol, 1998, 13(11) : 546.
  • 6Chung S, Choi J, Hyun T, et al. Alterations in the carnitine metabolism in epileptic children treated with valproic acid. J Korean Med Sci, 1997, 12(6) : 553.
  • 7De Vivo DC, Bohan TP, Coulter DL, et al. L-carnitine supplementation in childhood epilepsy: current perspectives. Epilepsia, 1998, 39 (11): 1216.
  • 8Shuper A, Gutman A, Mimouni M. Intractable epilepsy. Lancet, 1999, 353(9160) : 1238.
  • 9Coppola G, Epifanio G, Auficchio G, et al. Plasma free caruitine in epilepsy children, adolescents and young adults treated with old and new antiepileptic drugs with or without ketogenic diet. Brain Dev, 2006, 28(6) : 358.
  • 10Verrotti A, Greco R, Morgese G, et al. Carnitine deficiency and hyperammonemia in children receiving valproic acid with and without other anticonvulsant drugs. Int J Clin Lab Res, 1999, 29(1) : 36.

共引文献59

同被引文献169

引证文献19

二级引证文献78

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部