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目的:了解丙戊酸钠用于成年患者致血小板减少症的特点,从而帮助避免或减少该不良反应(ADR)的发生。方法:查阅中国期刊全文数据库、万方数据库、Pub Med数据库关于丙戊酸钠用于成年患者致血小板减少症的病例报道,就ADR相关情况进行统计、分析。结果:9例ADR病例应用丙戊酸钠剂量为0.3~2.25 g/d,频次为每日1~3次;2例为静脉给药,7例为口服给药;出现ADR时间为开始用药后2 d~5个月,甚至更长;3例分别合用了抗癫痫药物、抗精神病药物和抗高血压药物;大部分病例停药后8~10 d血小板恢复正常。结论:丙戊酸钠应用时间长、累积剂量较高、合并多种药物时容易致血小板减少症发生。临床应该引起重视,发现ADR时应立即停药并对症处理。建议用药过程应注意监测血常规及肝功能。
Objective: To understand the characteristics of sodium valproate for thrombocytopenia in adult patients, so as to help prevent or reduce the incidence of this adverse reaction (ADR). Methods: The Chinese Journal Full-text Database, Wanfang Database, Pub Med database for the case of sodium valproate in patients with thrombocytopenia reported in the case of ADR related statistics, analysis. Results: The dosage of sodium valproate in 9 ADR cases was 0.3 ~ 2.25 g / d, the frequency was 1 ~ 3 times a day, 2 cases were intravenously administered and 7 cases were orally administered. The ADR occurred after the start of medication 2 d ~ 5 months, or even longer; 3 cases were combined with anti-epileptic drugs, antipsychotic drugs and antihypertensive drugs; most cases 8-10 days after withdrawal of platelets returned to normal. Conclusion: Sodium valproate has been used for a long time and has a high cumulative dose. It is easy to cause thrombocytopenia when multiple drugs are combined. Clinical should pay attention, found that ADR should be discontinued immediately and symptomatic treatment. Recommended medication should pay attention to monitoring blood and liver function.