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目的 探讨丙戊酸钠 (VPA)对癫疒间 患儿血小板数量及功能的影响。方法 对 38例服用不同剂量VPA的癫疒间患儿分别于服药前、服药 3个月和 6个月时检测其血小板数量、血小板聚集率、血栓素B2 (TXB2 )和6 酮 前列腺素 F 1α(6 Keto PGF 1α)的水平。结果 服用VPA 3个月与服药前比较 ,血小板计数明显减少 (t =2 82 4 ,P <0 0 1) ,且与VPA剂量呈负相关 ;胶原和二磷酸腺苷 (ADP)诱导的血小板聚集率显著下降 (t =2 15 3和 2 2 6 3,P均 <0 0 5 ) ,与VPA剂量呈负相关 ;TXB2 显著下降 (t =2 373,P <0 0 5 ) ,与VPA剂量不相关 ;6 Keto PGF 1α无明显变化。服药 6个月与 3个月比较 ,上述各指标差异无显著性。全身性发作组与部分性发作组比较 ,上述各指标无显著性差异。结论 VPA能影响癫疒间 患儿的血小板数量及功能 ,影响的程度与VPA剂量相关 ,与癫疒间 患儿的发作类型无关。
Objective To investigate the effects of valproate (VPA) on the number and function of platelets in children with epilepsy. Methods Thirty-eight children with epilepsy with different doses of VPA were taken to measure the number of platelets, platelet aggregation, thromboxane B2 (TXB2) and 6-ketoprostaglandin F 1α before treatment, 3 months and 6 months after treatment. (6 Keto PGF 1α) levels. Results The platelet count was significantly decreased at 3 months after taking VPA compared with that before administration (t = 2 82 4, P <0.01), and negatively correlated with VPA dose. Platelet aggregation induced by collagen and adenosine diphosphate (ADP) (T = 2 15 3 and 2 2 6 3, P <0 05), but negatively correlated with VPA dose. TXB2 decreased significantly (t = 2 373, P 0 05) Related; 6 Keto PGF 1α no significant change. Taking medicine for 6 months and 3 months, there was no significant difference between the above indexes. Compared with the partial seizure group, there was no significant difference in the above indexes between the general seizure group and the partial seizure group. Conclusions VPA can affect the number and function of platelets in children with epilepsy. The extent of the effect is related to the dose of VPA and has nothing to do with the type of seizures in children with epilepsy.