Analysis of effects of valproic acid on the level of plasma fibrinogen in epileptic patients and the related factors

TANG Jing; YANG Jia-wen; QI Xiao-lian

doi:10.3969/j.issn.1672-8157.2018.05.001

Abstract：Objective: To explore the effects of valproic acid on the level of plasma fibrinogen (Fib) in epileptic patients and the related factors. Methods: The medical records of the inpatients with epilepsy who were treated with valproic acid in our hospital from January 1st2017 to March 1st2017 were collected, which included age, sexuality, height, body weight, clinical diagnosis, administration regimen of valproic acid, drug combination, lab results of liver function, blood routine, coagulation function and so on. The patients were divided into low Fib level group (< 2.0 g·L-1) and normal group. The risk factors related to low Fib level after administration of valproic acid were analyzed by multivariate Logistic regression method. ROC analysis was conducted to explore the predictor of low Fib level. Results: A total of 59 patients were enrolled into this study. There were 24 cases in low Fib level group and 35 cases in the normal group. Compared with results of normal group, the proportion of children, dose of valproic acid, the values of INR, PT and TT in low Fib level group were significantly higher (P < 0.05), while the values of NEUT%, RBC and PTA in low Fib level group were significantly lower (P < 0.05). All patients in low Fib level group didn't develop serious coagulation disorder and bleeding. So valproic acid continued and no symptomatic treatment was given to them. The results of Logistic regression analysis showed that dose of valproic acid [OR = 1.133, 95%CI(1.046, 1.227), P = 0.002) was the risk factor of Fib reduction caused by valproic acid. The results of ROC analysis showed that dose ≥ 13.311 7 mg·kg-1·d-1was an effect predictor for Fib reduction caused by valproic acid. Conclusion: Fib reduction induced by valproic acid were common in clinic. Close monitoring were needed for patients who took more than 13.311 7 mg·kg-1·d-1valproic acid.