Rehabilitation Psychiatry, Northumberland, Tyne and Wear NHS Trust, Newcastle upon Tyne, United Kingdom.
J Clin Psychopharmacol. 2010 Jun;30(3):282-5. doi: 10.1097/JCP.0b013e3181db2684.
Sodium valproate is an anticonvulsant that is also one of the common treatments used for bipolar disorder. The present study was conducted in psychiatric patients with the aim of examining the effects of valproate on hematological parameters and to explore any association with sex and age.
A list of all psychiatric patients who underwent valproate level estimation in the years 2004-2008 in Newcastle upon Tyne was drawn from the biochemistry database of the local hospital. The names and date of births of these patients were used to draw corresponding hematological data, including hemoglobin, white blood cell count, mean corpuscular volume (MCV), and platelet count, conducted on the same day or within a week of the valproate level measurement.
: The data from 126 patients were analyzed. The prevalence of thrombocytopenia (platelet count, <150,000/microL) was found to be approximately 5%. In female subjects, a significant negative correlation was found between serum valproate level and platelet count; also, a positive correlation between valproate level and MCV was found. Neither correlation was found in male subjects. The risk of a low platelet count was found to be significantly increased at serum valproate level above 80 microg/mL in female subjects. The regression analysis in female patients showed a trend toward fall in platelet count and an increase in MCV with increasing age.
In psychiatric patients on valproate therapy, close monitoring of full blood count is required in women particularly at valproate serum level above 80 microg/mL. This may be particularly important in older patients.
丙戊酸钠是一种抗惊厥药物，也是治疗双相情感障碍的常用药物之一。本研究在精神科患者中进行，旨在研究丙戊酸钠对血液学参数的影响，并探讨其与性别和年龄的关系。
从当地医院的生化数据库中列出了 2004 年至 2008 年在泰恩河畔纽卡斯尔接受丙戊酸钠水平评估的所有精神科患者的名单。使用这些患者的姓名和出生日期来提取相应的血液学数据，包括血红蛋白、白细胞计数、平均红细胞体积（MCV）和血小板计数，这些数据是在丙戊酸钠水平测量的同一天或一周内进行的。
对 126 名患者的数据进行了分析。血小板减少症（血小板计数<150,000/μL）的患病率约为 5%。在女性患者中，血清丙戊酸钠水平与血小板计数呈显著负相关；此外，丙戊酸钠水平与 MCV 呈正相关。在男性患者中未发现这种相关性。在女性患者中，血清丙戊酸钠水平超过 80μg/mL 时，血小板计数低的风险显著增加。在女性患者的回归分析中，血小板计数呈下降趋势，MCV 呈上升趋势，随着年龄的增长而增加。
在接受丙戊酸钠治疗的精神科患者中，特别是在女性患者中，丙戊酸钠血清水平超过 80μg/mL 时，需要密切监测全血细胞计数。对于老年患者，这可能尤为重要。
