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本文目的在于提出丙戊酸钠(VPA)的一般性副作用,不包括肝毒性及致畸胎作用。常见副作用概况根据16份资料,归纳总结了1140例服 VPA 病人的最常见副作用。一般报道,在剂量不大时,此药的副作用是轻而短暂的,且出现在治疗的早期。嗜睡是 VPA 与苯巴比妥合用时最常见的副作用,因 VPA 通过对其代谢的抑制而增加了苯巴比妥的血浆浓度。当空腹血浆 VPA 浓度低至21.8～56.5μg/ml 时,也见嗜睡和轻度共济失调。然而,有的病人在相似甚至稍高的药浓度时,蓝不嗜睡。近年来由于肠衣制剂的应用,恶心、呕吐、胃肠道不适的发生率已大大降低。据1976年 Noronha 及 Bev-an 报道,3328例病人因胃肠道症状严重须停服 VPA 的,成人占0.9%,儿童占2.9%。另有报道,胃肠道不适时血浆 VPA 浓度是34～92μg/ml,脱发时是23～65μg/ml,震颤时其
The purpose of this article is to propose general side effects of sodium valproate (VPA), excluding hepatotoxicity and teratogenic effects. Common side effects profile Based on 16 data, summarized the most common side effects of 1140 patients taking VPA. It is generally reported that side effects of this medicine are mild and transient at low doses and occur early in treatment. Sleepiness is the most common side effect of VPA with phenobarbital, as VPA increases phenobarbital plasma concentrations by inhibiting its metabolism. When fasting plasma VPA concentrations as low as 21.8 ~ 56.5μg / ml, also see the drowsiness and mild ataxia. However, some patients are not sleepy at similar or even slightly higher drug concentrations. In recent years due to the application of enteric-coated preparations, nausea, vomiting, gastrointestinal discomfort has greatly reduced the incidence. According to a report by Noronha and Bev-1976 in 1976, 3,328 patients had to stop taking VPA due to severe gastrointestinal symptoms, accounting for 0.9% of adults and 2.9% of children. Another reported gastrointestinal discomfort when the plasma VPA concentration is 34 ~ 92μg / ml, hair loss is 23 ~ 65μg / ml, when tremor