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1
Routine screening of blood and urine for severe reactions to anticonvulsant drugs in asymptomatic patients is of doubtful value.对无症状患者进行血液和尿液常规筛查以检测对抗惊厥药物的严重反应，其价值存疑。
CMAJ. 1989 Jun 1;140(11):1303-5.
2
Asymptomatic children with epilepsy: little benefit from screening for anticonvulsant-induced liver, blood, or renal damage.癫痫无症状儿童：抗惊厥药所致肝、血液或肾损害筛查获益甚微。
Neurology. 1986 Jun;36(6):838-41. doi: 10.1212/wnl.36.6.838.
3
Acute and chronic toxicity of antiepileptic medications: a selective review.抗癫痫药物的急性和慢性毒性：选择性综述
Can J Neurol Sci. 1994 Aug;21(3):S7-11. doi: 10.1017/s0317167100040750.
4
Fallacy in using urine tests as indicators of anticonvulsant drug toxicity.将尿液检测用作抗惊厥药物毒性指标的谬误。
AMA Am J Dis Child. 1954 Jul;88(1):67-71. doi: 10.1001/archpedi.1954.02050100069008.
5
[Monitoring of various biohumoral parameters in convulsions in children undergoing long-term treatment with anticonvulsant drugs].[长期接受抗惊厥药物治疗的儿童惊厥时各种生物体液参数的监测]
Riv Neurobiol. 1981 Jul-Dec;27(34):438-48.
6
Evaluation of Lymphocyte Transformation Test Results in Patients with Delayed Hypersensitivity Reactions following the Use of Anticonvulsant Drugs.抗惊厥药物使用后迟发型超敏反应患者淋巴细胞转化试验结果的评估
Int Arch Allergy Immunol. 2016;170(3):158-62. doi: 10.1159/000448284. Epub 2016 Aug 25.
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Toxic effects of drugs used in the ICU. Anticonvulsant agents.重症监护病房使用药物的毒性作用。抗惊厥药。
Crit Care Clin. 1991 Jul;7(3):521-32.
8
The prevalence of adverse reactions to anticonvulsants in children with epilepsy.癫痫患儿对抗惊厥药物不良反应的发生率。
S Afr Med J. 1989 Jun 3;75(11):535-7.
9
Monitoring for adverse effects of antiepileptic drugs.监测抗癫痫药物的不良反应。
Epilepsia. 2006;47 Suppl 1:31-4. doi: 10.1111/j.1528-1167.2006.00657.x.
10
Liver function tests in persons receiving anticonvulsant medications.
Seizure. 1992 Sep;1(3):187-90. doi: 10.1016/1059-1311(92)90024-u.

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Black-Box Warnings of Antiseizure Medications: What is Inside the Box?抗癫痫药物的黑框警告：盒子里装的是什么？
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Mitochondrial dysfunction as a mechanism of drug-induced hepatotoxicity: current understanding and future perspectives.线粒体功能障碍作为药物性肝毒性的一种机制：当前认识与未来展望
J Clin Transl Res. 2018 May 28;4(1):75-100. doi: 10.18053/jctres.04.201801.005.
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Felbamate in epilepsy therapy: evaluating the risks.非氨酯用于癫痫治疗：评估风险
Drug Saf. 1999 Sep;21(3):225-39. doi: 10.2165/00002018-199921030-00006.
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Dalhousie's Pediatric Neurology Group: "We throw rocks at our glass house".达尔豪斯大学儿科神经学团队：“我们向自己的玻璃房扔石头”。
CMAJ. 1993 Nov 15;149(10):1510-1, 1514-5.
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Renal tubular dysfunction following treatment with anti-epileptic drugs.
Eur J Pediatr. 1994 Nov;153(11):855-8. doi: 10.1007/BF01972897.

本文引用的文献

1
HAEMATOLOGICAL ASPECTS DURING TREATMENT WITH ANTICONVULSANT DRUGS.抗惊厥药物治疗期间的血液学方面
Epilepsia. 1965 Mar;6:1-15. doi: 10.1111/j.1528-1157.1965.tb03345.x.
2
Hematological monitoring during therapy with carbamazepine in children.儿童使用卡马西平治疗期间的血液学监测。
Ann Neurol. 1983 Jun;13(6):685-6. doi: 10.1002/ana.410130622.
3
Anticonvulsant-induced aplastic anemia: increased susceptibility to toxic drug metabolites in vitro.抗惊厥药所致再生障碍性贫血：体外对毒性药物代谢产物敏感性增加。
Blood. 1983 May;61(5):889-93.
4
Predisposition to phenytoin hepatotoxicity assessed in vitro.体外评估苯妥英肝毒性易感性。
N Engl J Med. 1981 Sep 24;305(13):722-7. doi: 10.1056/NEJM198109243051302.
5
Valproate hepatotoxicity: two new cases, a summary of others, and recommendations.
Pediatr Neurol. 1985 Mar-Apr;1(2):109-13. doi: 10.1016/0887-8994(85)90046-3.
6
Asymptomatic children with epilepsy: little benefit from screening for anticonvulsant-induced liver, blood, or renal damage.癫痫无症状儿童：抗惊厥药所致肝、血液或肾损害筛查获益甚微。
Neurology. 1986 Jun;36(6):838-41. doi: 10.1212/wnl.36.6.838.
7
Erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and phenytoin.接受头颅照射和苯妥英治疗的患者出现多形红斑和史蒂文斯-约翰逊综合征。
Neurology. 1988 Feb;38(2):194-8. doi: 10.1212/wnl.38.2.194.
8
Valproic acid hepatic fatalities: a retrospective review.丙戊酸导致的肝脏死亡病例：一项回顾性研究。
Neurology. 1987 Mar;37(3):379-85. doi: 10.1212/wnl.37.3.379.
9
Effect of valproic acid on hepatic function.
Neurology. 1978 Sep;28(9 Pt 1):961-4. doi: 10.1212/wnl.28.9.961.

对无症状患者进行血液和尿液常规筛查以检测对抗惊厥药物的严重反应，其价值存疑。

Routine screening of blood and urine for severe reactions to anticonvulsant drugs in asymptomatic patients is of doubtful value.

作者信息

Camfield P, Camfield C, Dooley J, Farrell K, Humphreys P, Langevin P

机构信息

Izaak Walton Killam Hospital for Children, Halifax.

出版信息

CMAJ. 1989 Jun 1;140(11):1303-5.

PMID:2655854
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1269189/
Abstract

Severe or fatal reactions to anticonvulsant agents are fortunately rare. We examined the value of routine screening of blood and urine to detect early signs of such reactions in asymptomatic patients. The basic assumptions of this type of screening program have been faulty or unproven, and the results of studies, although not definitive, have not supported the value of such programs. Our recommendations, approved by the Canadian Association for Child Neurology, suggest that asymptomatic patients not undergo routine screening of blood and urine but, rather, be informed of the early symptoms of severe toxic reactions and be asked to report them immediately to a physician.

摘要

幸运的是，对抗惊厥药物的严重或致命反应很少见。我们研究了对无症状患者进行血液和尿液常规筛查以检测此类反应早期迹象的价值。这类筛查项目的基本假设存在错误或未经证实，并且研究结果虽然不明确，但并不支持此类项目的价值。我们的建议经加拿大儿童神经病学协会批准，建议无症状患者不要进行血液和尿液常规筛查，而是应被告知严重毒性反应的早期症状，并被要求立即向医生报告这些症状。