拉莫三嗪联合丙戊酸钠治疗小儿癫痫临床观察

目的探讨拉莫三嗪联合丙戊酸钠治疗小儿癫痫的效果及安全性。方法 116例癫痫患儿根据治疗方法分为联合组（拉莫三嗪联合丙戊酸钠治疗）58例,对照组（单用丙戊酸钠治疗）58例,比较2组总治疗效果、不同癫痫发作类型的治疗效果及不良反应。结果治疗12个月后,联合组无发作36例,显效10例,有效6例,无效6例,总有效率89.7%;对照组无发作30例,显效7例,有效5例,无效16例,总有效率72.4%,2组总有效率比较差异有统计学意义（P〈0.05）;联合组治疗单纯部分发作、复杂部分发作、继发性全身发作、全身强直阵挛发作及肌阵挛发作有效率均高于对照组（P〈0.05）;不良反应发生率联合组（12.1%）与对照组（10.3%）比较差异无统计学意义（P〉0.05）。结论拉莫三嗪联合丙戊酸钠治疗各种类型癫痫效果均较好,且不良反应轻。     

FPIA法和HPLC法监测丙戊酸血药浓度的比较研究

目的:比较荧光偏振免疫分析法(FPIA)和高效液相色谱法(HPLC)监测丙戊酸血清药物浓度的相关性。方法:收集癫痫患者服丙戊酸后的稳态谷浓度血样,分别用FPIA法和HPLC法进行测定,考察二种测定方法的相关程度。结果:以HPLC法测定结果(x)与FPIA法测定结果(y)所作线性回归方程如下:y=1.8163+0.8407x(r=0.944),二种方法测定丙戊酸血清药物浓度结果差异有统计学意义(P<0.05)。结论:FPIA法和HPLC法测定丙戊酸血药浓度结果差异具有统计学意义,在丙戊酸治疗药物监测中应予以关注并作相应调整。     

丙戊酸镁与丙戊酸钠及碳酸锂治疗躁狂发作对照研究

目的：比较丙戊酸镁与丙戊酸钠及碳酸锂治疗双向情感障碍的疗效及不良反应。方法：将120例双相情感障碍躁狂发作的患者随机均分为丙戊酸镁组、丙戊酸钠组及碳酸锂组,在治疗前,治疗2、4、6周末分别用Bech-Rafaels—en躁狂量表（BRMS）和临床疗效总评量表（CGI）及副反应量表（T段S）评定疗效和不良反应。结果：三组治疗2、4、6周后BRMS总分,及各因子分比治疗前明显降低,差异显著。治疗2、4、6周末TESS评分,丙戊酸镁组分别显著低于丙戊酸钠及碳酸锂组,差异有显著性,丙戊酸钠组显著低于碳酸锂组,差异有显著性。结论：丙戊酸镁治疗躁狂发作疗效好,起效快,不良反应小。     

Hypoxia activates glycogen synthase kinase-3 in mouse brain in vivo: protection by mood stabilizers and imipramine.

BACKGROUND: Glycogen synthase kinase-3 (GSK3), which is primarily regulated by an inhibitory phosphorylation of an N-terminal serine, has been implicated as contributing to mood disorders by the finding that it is inhibited by the mood stabilizer lithium. METHODS: This study tested if the antidepressant imipramine or the mood stabilizers lithium and sodium valproate regulated pathophysiological serine-dephosphorylation of GSK3 caused by hypoxia in mouse brain in vivo. RESULTS: Hypoxia caused rapid serine-dephosphorylation of both isoforms of GSK3, GSK3beta and GSK3alpha, in mouse cerebral cortex, hippocampus, and striatum. Pretreatment of mice with imipramine, sodium valproate, or lithium attenuated hypoxia-induced serine-dephosphorylation of GSK3beta and GSK3alpha in all three brain regions. CONCLUSIONS: These results demonstrate that imipramine and mood stabilizers are capable of blocking pathophysiologically induced serine-dephosphorylation of GSK3, supporting the hypothesis that stabilization of serine-phosphorylation of GSK3 contributes to their therapeutic effects.     

A possible anti-emetic role for sodium valproate in cytotoxic chemotherapy

We report two patients with acute leukaemia who received emetogenic cytotoxic drugs and were on therapeutic doses of sodium valproate for epilepsy. Neither patient reported significant nausea nor vomited at any time during the chemotherapy, at times requiring no anti-emetic treatment whatsoever. We suggest that this absence of nausea was due to an anti-emetic effect of sodium valproate.     

丙戊酸镁与苯噻啶对偏头痛的疗效比较

目的：比较丙戊酸镁与苯噻啶对偏头痛的疗效。方法：偏头痛病人６９例，分为丙戊酸镁组４１例（男性１８例，女性２３例，年龄３４±ｓ８ａ），用丙戊酸镁０．２～０．４ｇ，ｐｏ，ｂｉｄ或ｔｉｄ；苯噻啶组２８例（男性１２例，女性１６例，年龄３３±１１ａ），用苯噻啶０．５～１．０ｍｇ，ｐｏ，ｔｉｄ，疗程均为１２ｗｋ。结果：２组总有效率差别不显著（Ｐ＞０．０５），但２组基本控制率差别非常显著（Ｐ＜０．０１）。２组不良反应均较轻微，无１例终止治疗。结论：丙戊酸镁对偏头痛的基本控制率优于苯噻啶，是一种有效的治疗偏头痛的药物     

Lack of relationship between sodium valproate-induced adverse effects and the plasma concentration of its metabolite 2-propylpenten-4-oic acid

Summary The concentrations of valproic acid (VPA) and of its metabolites 3-oxo-VPA and 4-en-VPA were measured in the plasma of 12 selected epileptic patients 1,2,3, and 4 h after administration of a loading dose of VPA. Four of the patients, all on polytherapy, had had short-term adverse effects during chronic VPA treatment, and in them there has been abnormal NH₃-values after a test doese of VPA. Eight patients (4 on monotherapy and 4 on polytherapy) had been free from adverse effects. No significant difference in the VPA, 3-oxo-VPA and 4-en-VPA concentrations was found between the three groups of patients. Accumulation of 4-en-VPA is not involved in the short-term adverse effects and hyperammonaemia induced by VPA.