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首页> 外文期刊>Psychosomatics >Valproate-Induced Hyperammonemic Encephalopathy in General Hospital Patients With One or More Psychiatric Disorders
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Valproate-Induced Hyperammonemic Encephalopathy in General Hospital Patients With One or More Psychiatric Disorders

机译：一般医院患者的Valproate诱导的高血肿性脑病，一种或多种精神病患者

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Background: Divalproex sodiumlvalproic acid (VPA) is an antiepileptic drug approved for use in epilepsy and bipolar disorder. Valproate-induced hyperammonemia occurs in up to 50% of VPA-treated patients, some of whom may become encephalopathic. Valproate-induced hyperammonemic encephalopathy (VHE) is thought to be rare, and for a variety of reasons, the diagnosis requires a high index of suspicion. Objective: The study's goals are to determine how common VHE is, and the quality of treatment provided when diagnosed Methods: Retrospective, cross-sectional survey of general hospital patients. The hospital's laboratory and pharmacy databases were combined to identify a cohort of all VPA-treated patients who developed hyperammonemia during a 5-year period Hospital records of the subset of patients with a psychiatric disorder were selected and reviewed for data collection. Results: Twenty of 793 (2.52%) VPA-treated patients had signs and symptoms consistent with VHE. The majority were White males on multiple psychotropic agents. Valproate was appropriately discontinued in 8 (40%) patients. Lactulose was the only ammonia-lowering drug used, and it was administered to 6 patients and only one among them had VPA discontinued Conclusion: Study results indicate that VHE may be more common in psychiatric patients than previously assumed but underrecognized and inadequately treated The diagnosis of VHE requires a high index of suspicion. Outcome is favorable once it is recognized and treated appropriately.
机译：背景：DivallProex钠戊酸（VPA）是一种批准用于癫痫和双相障碍的抗癫痫药物。 Valproate诱导的高血肿性高达50％的VPA治疗患者，其中一些人可能会成为脑病。丙戊酸诱导的高血肿性脑病（VHE）被认为是罕见的，由于各种原因，诊断需要高度怀疑。目的：该研究的目标是确定常见的VHE和诊断方法时的治疗质量：综合医院患者的回顾性，横断面调查。该医院的实验室和药房数据库被组合以确定选择并审查了在精神病疾病患者患者子集的5年期医院记录中开发了高肿瘤血症的所有VPA治疗患者的队列。结果：20分793（2.52％）VPA治疗的患者患有与VHE一致的迹象和症状。大多数是多个精神药物上的白人男性。在8（40％）患者中，丙戊酸丙醛妥善终止。乳膜是唯一使用的氨水药物，它被施用至6例患者，其中只有一个中间的VPA停止结论：研究结果表明，在精神病患者中，VHE可能比以前假定的诊断更令人难以识别，但诊断VHE需要高度怀疑。结果是有利的，一旦被识别和适当地对待。

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