丙戊酸钠对癫痫患儿脂质代谢的影响

Influence of Valproate on Lipid Metabolism in Epilepsy Children

目的:通过对服用丙戊酸钠(VPA)的癫痫患儿肝功能和血脂的变化的观察,并对其影响因素进行分析,指导在临床工作中合理用药。方法:对54例不同年龄癫痫患儿分别比较服药前和服药3个月后的体质量指数(BMI)、瘦素、胰岛素、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的水平。结果:VPA治疗3个月后BMI、瘦素、胰岛素、HOMA指数、TC、TG、LDL-C均较治疗前明显升高(P<0.05),而血糖则明显下降(P<0.05)。结论:VPA确有导致癫痫患儿肥胖的作用,且多在服用VPA3个月内发生。VPA所致的肥胖与单纯性肥胖相似,但又不完全相同。对需要长期接受丙戊酸钠治疗的癫痫患儿,对其血脂监测的意义在于动态比较分析,而不该局限于该值是否正常。

Objective： To know the change of body mass index（BMI） and hpid levels in children with epilepsy who use VPA, in order to guide the clinic rational administration of VPA and minimize the side effects. Method： The BMI, TG, TC, HDL-C, LDL- C, INSULIN and the LEPTIN from 54 different age children with epilepsy were compared before with after VPA therapy 3 months. Re- suit： When comparing 3 months before and after VPA therapy,the lecels of their BMI,leptin,insulin,HOMA,TC,TG and LDL-C in the later group were all significantly highter than those of the former one （ P 〈 0. 05 ）, while the blood glucose level decreased signifi- cantly （ P 〈 0. 05）. Conclusion： VPA do have the efficacy of causing obesity in the children with epilepsy, and most of the cases occurred in the first 3 months after VPA being prescribed. There are the differences between the obesity caused by VPA and simple obesity.