Dickinson R G, Bassett M L, Searle J, Tyrer J H, Eadie M J
Clin Exp Neurol. 1985;21:79-91.
Two patients with severe liver damage induced by sodium valproate are described. Both were adults. One had taken valproate for longer than one year before complications developed. The other, in whom the disorder was fatal, had a predominantly 'hepatic' pattern of liver damage with centrilobular necrosis and he also developed pancreatitis. The first patient, who recovered following cessation of valproate intake, manifested a predominantly cholestatic illness with portal tract inflammation. In addition he had a degree of reversible renal failure. Neither subject had microvesicular steatosis on liver biopsy. This report indicates that valproate hepatotoxicity is not always confined to children, that it may develop much later in the course of valproate therapy than has been previously recognized, that it is not necessarily fatal if valproate intake is ceased early enough, and that it may be associated with reversible renal insufficiency.
本文描述了两名因丙戊酸钠导致严重肝损伤的患者。两名患者均为成年人。其中一名患者在出现并发症前服用丙戊酸盐超过一年。另一名患者病情 fatal（原文有误，推测可能是“fatal”，意为致命），其肝损伤主要表现为“肝型”，伴有小叶中心坏死，还并发了胰腺炎。第一名患者在停用丙戊酸盐后康复，表现为以胆汁淤积为主的疾病，伴有门管区炎症。此外，他还出现了一定程度的可逆性肾衰竭。两名患者肝活检均未发现微泡性脂肪变性。本报告表明，丙戊酸盐肝毒性并不总是局限于儿童，它可能在丙戊酸盐治疗过程中比之前认识到的更晚出现，若尽早停用丙戊酸盐不一定 fatal（推测为“致命”），且可能与可逆性肾功能不全有关。
