Du Zhaosong, Wang Jun, Nie Gang, Li Ying, Liu Maochang
Department of Pharmacy, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430016, Hubei, China.
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
Sci Rep. 2025 Apr 21;15(1):13675. doi: 10.1038/s41598-025-98870-8.
Thrombocytopenia is one of the side effects of VPA. This study aimed to evaluate the incidence and risk factors of thrombocytopenia after intravenous VPA treatment in children with neurosurgical operations. Pediatric patients undergoing neurosurgical operations treated with intravenous VPA were enrolled in this retrospective study. According to platelet count after intravenous injection of VPA, the pediatric patients were divided into the thrombocytopenia group and the non-thrombocytopenia group. Binary logistic regression analysis was used to explore the risk factors for thrombocytopenia. A total of 252 children with neurosurgical operations were included in this study, and the incidence of thrombocytopenia was 12.3% (31/252). Univariate analysis showed that baseline platelet count, duration of VPA therapy, and blood loss were associated with the occurrence of thrombocytopenia after intravenous administration of VPA. Binary logistic regression revealed that baseline platelet count (OR 0.995, 95% CI 0.991-0.999) and blood loss (OR 0.995, 95% CI 0.991-0.999) were independent risk factors for thrombocytopenia after intravenous VPA in children undergoing neurosurgical operations. Our data show that thrombocytopenia is common in neurosurgical operations children treated with intravenous VPA, and that baseline platelet count is an independent risk factor for thrombocytopenia. Regular monitoring of baseline platelet count is important for whether to short-term prophylactic use intravenous VPA in children undergoing neurosurgical operations.
血小板减少症是丙戊酸（VPA）的副作用之一。本研究旨在评估神经外科手术患儿静脉注射VPA治疗后血小板减少症的发生率及危险因素。本回顾性研究纳入了接受静脉注射VPA治疗的神经外科手术患儿。根据静脉注射VPA后的血小板计数，将患儿分为血小板减少组和非血小板减少组。采用二元逻辑回归分析探讨血小板减少症的危险因素。本研究共纳入252例神经外科手术患儿，血小板减少症的发生率为12.3%（31/252）。单因素分析显示，基线血小板计数、VPA治疗时长及失血量与静脉注射VPA后血小板减少症的发生有关。二元逻辑回归显示，基线血小板计数（比值比[OR]0.995，95%置信区间[CI]0.991 - 0.999）和失血量（OR 0.995，95% CI 0.991 - 0.999）是接受神经外科手术患儿静脉注射VPA后血小板减少症的独立危险因素。我们的数据表明，血小板减少症在接受静脉注射VPA治疗的神经外科手术患儿中很常见，且基线血小板计数是血小板减少症的独立危险因素。定期监测基线血小板计数对于神经外科手术患儿是否短期预防性使用静脉注射VPA很重要。
