丙戊酸钠对成人癫痫患者脂质代谢的影响

Effect of sodium valproate on lipid metabolism in epilepsy adult

目的探讨丙戊酸钠(VPA)对成人癫痫患者脂质代谢的影响。方法本试验为前瞻性研究,选择33例成人癫痫患者为试验组、36例健康人为对照组,分别检测试验组在VPA治疗前、治疗6mo后和对照组的血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)、致动脉粥样硬化率(TC/HDL-C和LDL-C/HDL-C)、体重指数(BMI),并进行比较。结果(1)试验组治疗前与对照组相比所有检测参数差异无显著意义(P>0.05),治疗6mo后TG、TC/HDL-C、LDL-C/HDL-C和BMI较对照组增高,HDL-C有减低趋势,差异有显著意义(P<0.05或P<0.01)。(2)试验组治疗前、后进行自身对照分析,治疗后TC、LDL-C、TC/HDL-C、LDL-C/HDL-C、BMI均较治疗前明显增高,HDL-C水平较治疗前下降,治疗前后比较差异有显著意义(P<0.05或P<0.01),而TG水平在治疗前后差异无显著意义(P>0.05)。(3)VPA治疗前后血脂谱和BMI的变化与各种危险因素(如年龄、性别、平均VPA剂量等)的相关性无显著意义(P>0.05)。结论VPA可导致成人癫痫患者脂质代谢异常和BMI增高。

AIM To evaluate the influence of sodium valproate （VPA） on lipid metabolism in epilepsy adult. METHODS This clinical trial was carried out prospective by involving 33 patients with epilepsy adult as trial group and 36 healthy volunteers as control group. Plasma TC, TG, LDL-C, HDL-C, TC / HDL-C, LDL-C / HDL-C, BMI were determined for the control group and also for the trial group before the initiation and at 6 mo after the VPA treatment; and then followed by comparing the correlative parameters between the two groupsand also parameters of the trial group before and after the treatment. RESULTS （ 1） All the pretreatment parameters showed no siginificant difference between the pretreatment parameters of the trial group and the control group （P 0.05）,while the levels of TG, TC / HDL-C, LDL-C / HDL-C and BMI in post-treatment parameters of the trial group were significantly higher than those of the control group but the level of HDL-C declined with significant difference （P 0.05, P 0.01） . （2） Comparing the parameters of pretreatment and posttreatment of the trial group showed remarkable increase of TC, LDL-C, TC / HDL-C, LDL-C / HDL-C, BMI and decrease of HDL-C with significant difference （P 0.05, P 0.01） in the post-treatment patients, but no significant difference in TG was shown. （3） There was no significant correlation （P 0.05） between serum lipid spectrum, BMI and various risk factors （including age, sex, mean VPA dosage, etc） before and after VPA treatment. CONCLUSION VPA may induce lipid metabolic disorders and the increment of BMI in epilepsy adult.