癫痫杂志

癫痫杂志

抗癫痫药物与华法林抗凝治疗的影响

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目的 探讨抗癫痫药物(AEDs)与华法林的凝血功能及血液系统的关联性,为临床医师在选择 AEDs 与华法林联合用药时提供参考。 方法 综合评价分析贵阳中医学院第二临床医学院于 2017 年 4 月 1 日收治 1 例症状性癫痫患者服用 AEDs 同时服用华法林的临床资料,明确其服药期间出现的不良反应,行相应处理,并结合文献进行分析。 结果 患者服用丙戊酸钠后凝血功能发生明显异常,出现危急值,立即停用华法林,逐渐减少丙戊酸钠用量,改为左乙拉西坦抗癫痫治疗。监测凝血功能恢复到正常水平后再次启动华法林抗凝治疗。 结论 有相关基础疾病的症状性癫痫,在抗癫痫治疗同时,针对共患病和基础疾病的治疗,联合用药,多种 AEDs 会影响华法林的抗凝作用,需考虑药物之间的相互作用,避免不良反应的发生。

Objective To investigate the effects of antiepileptic drugs (AEDs) with warfarin functions and blood coagulation system, to provide the reference for clinicians of the selection of AEDs under the combination therapy with warfarin. Methods Analyse the clinical data of the patient with symptomatic epilepsy from the Second Clinical Medical College of Guiyang University of Chinese Medicine on April 1, 2017, whom taking AEDs and warfarin at the same time, clear the drug adverse reactions, and analysed related literature. Results After the treatment with valproate, abnormal blood coagulation, a danger and emergency data appeared, so we stopped using warfarin immediately, and reduce the dosage of valproate gradually, insteadly, we used levetiracetam as antiepileptic therapy. Monitoring blood coagulation function, when it returned to normal, restart warfarin anticoagulant therapy. Conclusions When start antiepileptic treatment in relevant basic diseases of symptomatic epilepsy, for a variety of combination reactions, AEDs can affect the anticoagulant effect of warfarin, so we need to consider the interaction between drugs and avoid adverse reactions.

关键词: 抗癫痫药物; 华法林; 抗凝治疗; 不良反应

Key words: Antiepileptic drug; Warfarin; Anticoagulation; Adverse reactions

引用本文: 薛红, 翁柠, 王强. 抗癫痫药物与华法林抗凝治疗的影响. 癫痫杂志, 2019, 5(1): 26-29. doi: 10.7507/2096-0247.20190005 复制

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