拉莫三嗪及丙戊酸钠对癫痫患儿血脂的影响

Effect of Lamotrigine and Sodium Valproate on children with epilepsy

目的对比拉莫三嗪、丙戊酸钠以及2药联合治疗癫痫患儿的临床疗效及其对血脂水平的影响。方法选择本院收治的癫痫患儿83例,随机分为3组:拉莫三嗪组(LTG组)28例,予口服拉莫三嗪片;丙戊酸钠组(VPA组)27例,予口服丙戊酸钠片;联合组28例,先予口服丙戊酸钠片,再口服拉莫三嗪片。计算3组患者临床总有效率,比较治疗前、治疗6个月、12个月血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平。结果 LTG组和联合组总有效率(89.3%和92.9%)均明显高于VPA组(66.7%);联合组总有效率虽然高于LTG组,但差异无统计学意义。治疗后LTG组血脂水平变化不明显;VPA组TC、TG、LDL-C水平随着治疗时间的推移而不断上升,与治疗前比较,差异有统计学意义;而联合组在开始使用VPA时,血脂水平存在上升趋势,但在加用LTG后又逐渐恢复至治疗前水平。结论 LTG联合VPA较单用2药治疗癫痫患儿的临床疗效更佳,且对血脂无明显影响,值得临床推广应用。

Objective To compare the clinical effect and level of blood lipid of Lamotrigine （LTG） and Sodium Valproate （VPA） on children with epilepsy. Methods Eighty - three cases of children with epilepsy were divided into 3 groups： LTG group （ n = 28） received LTG tablets, VPA group （n = 27） received VPA tablets, and combined group （n = 28） received VPA before LTG. The total efficiency rates were calculated, and the levels of TC, TG, HDL - C, LDL - C before treatment, after 6 months and 12 months were compared. Results The total efficiency rates of the LTG group and the combined group （89.3 % and 92.9 % ） were higher than that of VPA group （66.7 % ）. Although the total efficiency rate in the combined group was higher than that of LTG group, there was no statistical difference. After treatment, there was no obvious change of blood lipid in the LTG group. The levels of TC, TG and LDL- C increased with time. The level of blood lipid in the combined group increased at the beginning of VPA treatment, but recovered to the level pre- treatment after LTG was added. Conclusion The clinical effect of LTG combined with VPA is better than LTG or VPA alone, and has little effect on the level of blood lipid. It＇s worth to be clinically popularized and applied.