Correlative study on the changes in liver function caused by sodium valproate in children with epilepsy_Journal of Epilepsy

Authors：

WENG Aibin ¹ , HUI Xiaoyu ² ,  LIN Qingshuang ¹

1. Department of Clinical Pharmacology, the Affiliated Hospital (Group) of Putian University, Putian 351100, China;
2. Pharmaceutical and Medical Technology College of Putian University, Putian 351100, China;

Corresponding author：

LIN Qingshuang, Email: linqingshuang1989@126.com

Keywords：

Valproic acid; Abnormal liver function; Blood drug concentration; Epilepsy

DOI：

10.7507/2096-0247.202111002

Video：

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Objective To study the correlation of changes in liver function during long-term treatment with sodium valproate (VPA) in children with epilepsy in Putian, and to explore individualized administration to improve the compliance of children with medication. Methods The blood concentration of VPA and related biochemical test data of 350 children with epilepsy from June 1, 2018 to March 1, 2021 were collected in our hospital. According to the results of VPA blood concentration, they were classified as low Blood concentration group (<50 μg/mL), therapeutic blood concentration group (50 ~ 100 μg/mL) and high blood concentration group (>100 μg/mL). Results There was no significant difference in liver function indexes between the VPA treatment group and the control group (P>0.05). There were significant differences in liver function ALT, AST, AST/ALT, TBIL and DBIL among the groups of VPA blood concentration range (P<0.05). The abnormal incidence of liver function indexes of high blood drug concentration was lower in the concentration group and higher in the treatment concentration group, and there were differences (P<0.05). Conclusion Abnormal liver function in the high blood drug concentration treatment groupis quite common, and the dose of the drug should be adjusted in time to avoid liver damage caused by the VPA.

Citation： WENG Aibin, HUI Xiaoyu, LIN Qingshuang. Correlative study on the changes in liver function caused by sodium valproate in children with epilepsy. Journal of Epilepsy, 2022, 8(2): 123-126. doi: 10.7507/2096-0247.202111002 Copy

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2.	Suller MA, Mirsattar SM, Macdougall K, et al. Vagus nerve stimulation in patients with therapy-resistant generalized epilepsy. Epilepsy Behav, 2020, 111: 107253.
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6.	唐静, 杨迦雯, 齐晓涟. 丙戊酸对癫痫患者血浆纤维蛋白原水平的影响及相关因素分析. 中国药物应用与监测, 2018, (5): 259-263.
7.	Shrestha A, Neupane HC, Tamraka KK, et al. Role of liver enzymes in patients with blunt abdominal trauma to diagnose liver injury. Int J Emerg Med, 2021, 14(1): 7.
8.	陈荣. CYP2C19基因多态性对癫痫儿童丙戊酸钠血药浓度的影响. 福建医科大学, 硕士学位论文, 2017: 1-42.
9.	Khatatbeh M, Momani W, Altaani Z, et al. Fast food consumption, liver functions, and change in body weight among university students: a cross-sectional study. Int J Prev Med, 2021, 12: 109.
10.	Kohsar M, Moradinazar M, Rahimi Z, et al. Liver enzymes and their association with some cardiometabolic diseases: evidence from a large Kurdish Cohort. Biomed Res Int, 2021, 2: 5584452.
11.	Liang CY, Chiang KL, Hsieh LP, et al. Prescription patterns and dosages of antiepileptic drugs in prevalent patients with epilepsy in Taiwan: a nationwide retrospective cross-sectional study. Epilepsy Behav, 2021, 126: 108450.
12.	Guk J, Lee SG, Chae D, et al. Optimal dosing regimen of Phenytoin for Korean epilepsy patients: from premature babies to the elderly. J Pharm Sci, 2019, 108(8): 2765-2773.
13.	吴作天, 王高华, 肖玲, 等. CYP2C19基因多态性在双相情感障碍患者丙戊酸盐使用所致肝功能变化中的作用. 武汉大学学报(医学版), 2021, 42(1): 119-122.
14.	Mei S, Feng W, Zhu L, et al. Effect of CYP2C19, UGT1A8, and UGT2B7 on valproic acid clearance in children with epilepsy: a populat ion pharmacokinetic model. Eur J Clin Pharmacol, 2018, 74(8): 1029-1036.
15.	谭喜莹, 张宇, 王淑云, 等. CYP2C9与CYP2C19基因多态性与癫痫患者丙戊酸血药浓度关系研究. 药学与临床研究, 2011, 19(2): 123-126.
16.	Bűdi, T, Tóth, K, Nagy A, et al. Clinical significance of CYP2C9-status guided valproic acid therapy in children. Epilepsia, 2015, 56(6): 849-855.

1. 方圆, 陈文武. 脑出血与癫痫. 河南大学学报(医学版), 2016, 35(3): 153-156.
2. Suller MA, Mirsattar SM, Macdougall K, et al. Vagus nerve stimulation in patients with therapy-resistant generalized epilepsy. Epilepsy Behav, 2020, 111: 107253.
3. Tomson T, Battino D, Perucca E. Valproic acid after five decades of use in epilepsy: time to reconsider the indications of a time-honoured drug. Lancet Neurology, 2016, (2): 210-218.
4. 倪敏, 周莉. 丙戊酸钠血药浓度监测对治疗儿童癫痫的临床意义研究. 中国全科医学, 2018, 21: 105-106.
5. Mei S, Feng W, Zhu L, et al. Genetic polymorphisms and valproic acid plasma concentration in children with epilepsy on valproic ac id monotherapy. Seizure, 2017, 51: 22-26.
6. 唐静, 杨迦雯, 齐晓涟. 丙戊酸对癫痫患者血浆纤维蛋白原水平的影响及相关因素分析. 中国药物应用与监测, 2018, (5): 259-263.
7. Shrestha A, Neupane HC, Tamraka KK, et al. Role of liver enzymes in patients with blunt abdominal trauma to diagnose liver injury. Int J Emerg Med, 2021, 14(1): 7.
8. 陈荣. CYP2C19基因多态性对癫痫儿童丙戊酸钠血药浓度的影响. 福建医科大学, 硕士学位论文, 2017: 1-42.
9. Khatatbeh M, Momani W, Altaani Z, et al. Fast food consumption, liver functions, and change in body weight among university students: a cross-sectional study. Int J Prev Med, 2021, 12: 109.
10. Kohsar M, Moradinazar M, Rahimi Z, et al. Liver enzymes and their association with some cardiometabolic diseases: evidence from a large Kurdish Cohort. Biomed Res Int, 2021, 2: 5584452.
11. Liang CY, Chiang KL, Hsieh LP, et al. Prescription patterns and dosages of antiepileptic drugs in prevalent patients with epilepsy in Taiwan: a nationwide retrospective cross-sectional study. Epilepsy Behav, 2021, 126: 108450.
12. Guk J, Lee SG, Chae D, et al. Optimal dosing regimen of Phenytoin for Korean epilepsy patients: from premature babies to the elderly. J Pharm Sci, 2019, 108(8): 2765-2773.
13. 吴作天, 王高华, 肖玲, 等. CYP2C19基因多态性在双相情感障碍患者丙戊酸盐使用所致肝功能变化中的作用. 武汉大学学报(医学版), 2021, 42(1): 119-122.
14. Mei S, Feng W, Zhu L, et al. Effect of CYP2C19, UGT1A8, and UGT2B7 on valproic acid clearance in children with epilepsy: a populat ion pharmacokinetic model. Eur J Clin Pharmacol, 2018, 74(8): 1029-1036.
15. 谭喜莹, 张宇, 王淑云, 等. CYP2C9与CYP2C19基因多态性与癫痫患者丙戊酸血药浓度关系研究. 药学与临床研究, 2011, 19(2): 123-126.
16. Bűdi, T, Tóth, K, Nagy A, et al. Clinical significance of CYP2C9-status guided valproic acid therapy in children. Epilepsia, 2015, 56(6): 849-855.

Journal of Epilepsy

Correlative study on the changes in liver function caused by sodium valproate in children with epilepsy

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