발프론산 유발 무증상 고암모니아혈증의 유병률 및 위험 인자에 대한 전향적 연구
Prospective Study on the Prevalence and Risk Factor of Valproate-Induced Asymptomatic Hyperammonemia
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Objectives：This is prospective study to identify the prevalence of hyperammonemia in patients who take valproate, and the characteristics of hyperammonemia group. Also, the study attempts to examine the factors affecting increase of ammonia. Methods：The study included 25 patients in Chung-Nam University hospital who were to take valproate. Socio-demographic information was collected. The level of ammonia in the blood was measured before taking valproate, and on the first, second, third, and fourth weeks after taking valproate. Also, liver function test, dose of valproate, therapeutic drug monitoring of valproate, and combined drugs were measured at each period. Fisher’s exact test, Mann-Whitney test, and Bivariate correlation analysis were conducted using SPSS, 18.0 version. Results：The prevalence of hyperammonemia induced from valproate was 72%. The highest level of ammonia was 227 mmol/L and the average of the highest level of ammonia was 69.1 mmol/L. There was no significant difference in gender, age, academic ability, dose of valproate, or therapeutic drug monitoring. Hyperammonemia is able to occur in normal liver function. The level of ammonia increased as the level of ammonia before taking valproate was higher and the level of taking benzodiazepine was lower. Conslusion：This study found that valproate induced hyperammonemia is common, which suggests it is necessary to measure blood ammonia level in patients taking valproate. This study could be useful to researches on encephalopathy caused by hyperammonemia, and suggests the necessity of following studies to identify risk factors affecting hyperammonemia.
Abstract
Objectives：This is prospective study to identify the prevalence of hyperammonemia in patients who take valproate, and the characteristics of hyperammonemia group. Also, the study attempts to examine the factors affecting increase of ammonia. Methods：The study included 25 patients in Chung-Nam University hospital who were to take valproate. Socio-demographic information was collected. The level of ammonia in the blood was measured before taking valproate, and on the first, second, third, and fourth weeks after taking valproate. Also, liver function test, dose of valproate, therapeutic drug monitoring of valproate, and combined drugs were measured at each period. Fisher’s exact test, Mann-Whitney test, and Bivariate correlation analysis were conducted using SPSS, 18.0 version. Results：The prevalence of hyperammonemia induced from valproate was 72%. The highest level of ammonia was 227 mmol/L and the average of the highest level of ammonia was 69.1 mmol/L. There was no significant difference in gender, age, academic ability, dose of valproate, or therapeutic drug monitoring. Hyperammonemia is able to occur in normal liver function. The level of ammonia increased as the level of ammonia before taking valproate was higher and the level of taking benzodiazepine was lower. Conslusion：This study found that valproate induced hyperammonemia is common, which suggests it is necessary to measure blood ammonia level in patients taking valproate. This study could be useful to researches on encephalopathy caused by hyperammonemia, and suggests the necessity of following studies to identify risk factors affecting hyperammonemia.
참고문헌 (24)
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