Dreifuss F E, Santilli N, Langer D H, Sweeney K P, Moline K A, Menander K B
Neurology. 1987 Mar;37(3):379-85. doi: 10.1212/wnl.37.3.379.
We reviewed all US cases of fatal hepatotoxicity coincident with valproate anticonvulsant therapy that were reported between 1978 and 1984. Thirty-seven hepatic fatalities were determined to have occurred coincident with the use of valproate. All but one patient had such other medical conditions as mental retardation, developmental delay, congenital abnormalities, and other neurologic diseases. The primary risk of fatal hepatic dysfunction (1/500) was found to be in children 0 to 2 years old receiving valproate as polytherapy. The risk declined with age and was low in patients receiving valproate as monotherapy (1/37,000). No hepatic fatalities occurred in patients above the age of 10 years receiving valproate as monotherapy.
我们回顾了1978年至1984年间美国报道的所有与丙戊酸抗惊厥治疗同时发生的致命肝毒性病例。确定有37例肝脏死亡与丙戊酸的使用同时发生。除1例患者外，所有患者都患有诸如智力迟钝、发育迟缓、先天性异常和其他神经系统疾病等其他病症。发现接受丙戊酸联合治疗的0至2岁儿童发生致命肝功能障碍的主要风险为1/500。该风险随年龄下降，接受丙戊酸单一疗法的患者风险较低（1/37,000）。接受丙戊酸单一疗法的10岁以上患者未发生肝脏死亡。
