左乙拉西坦对癫痫患儿性激素和甲状腺激素的影响

Effects of Levetiracetam on Sex Hormone and Thyroid Hormone of Epileptic Children

目的:考察左乙拉西坦对癫痫患儿性激素和甲状腺激素的影响,并评价其安全性。方法:选择2013年7月-2015年2月南通大学附属医院(以下简称"我院")初诊为癫痫的患儿22例,设为观察组;选择同期于我院行健康体检的儿童17例,设为对照组。观察组患儿给予左乙拉西坦片,起始剂量为10 mg/kg,每1～2周增加10 mg/(kg·d)[目标剂量为30～40 mg/(kg·d)],疗程为12个月。观察对照组儿童用药前和观察组患儿用药前以及用药后3、6、12个月的性激素[促卵泡生成素、促黄体生成素、垂体泌乳素、孕酮、睾酮、雌二醇]和甲状腺激素[总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]水平,记录观察组患儿不良反应发生情况。结果:用药前,两组受试者的性激素、甲状腺激素水平比较,差异均无统计学意义(P>0.05)。用药后3、6、12个月,观察组患儿性激素水平与用药前比较,差异均无统计学意义(P>0.05);用药后3、6个月,观察组患儿甲状腺激素水平与用药前比较,差异均无统计学意义(P>0.05);用药后12个月,TT3、TT4、FT4、TSH水平与用药前比较,差异均无统计学意义(P>0.05),而FT3水平较用药前显著升高,差异有统计学意义(P<0.05)。观察组患儿中有2例发生不良反应(9.1%),未经特殊处理,其症状均于发生1～2周后消失。结论:左乙拉西坦用于治疗儿童癫痫,对患儿的性激素水平无明显影响,但可升高其FT3水平。

OBJECTIVE： To investigate the effects of levetiracetam on sex hormone and thyroid hormone of epileptic children and to evaluate its safety. METHODS ： A total of 22 newly diagnosed epileptic children were selected from the Affiliated Hospital of Nantong University （hereinafter refferred as our hospital） during Jul. 2013-Feb. 2015 as observation group. During same period, 17 children underwent physical examination in our hospital were selected as control group. Observation group was given Levetiracetam tablets with initial dose of 10 mg/kg, increasing by 10 mg/（kg· d） every week or every two weeks [target dose of 30-40 mg/（kg· d）] for 12 months. The levels of sex hormone （follicle stimulating hormone, luteinizing hormone, prolactin, progesterone, testosterone and estradiol）and thyroid hormone （TT3, TT4, FT3, FT4, TSH）were observed before medication in control group and before and 3, 6, 12 months after medication in observation group. The occurrence of ADR was recorded in observation group. RESULTS： Before medication, there was no statistical significance in the levels of sex hormone or thyroid hormone between 2 groups （P〉0.05）. Three, six, twelve months after medication, there was no statistical significance in the levels of sex hormone in observation group compared to before medication （P〉0.05）. Three, six months after medication, there was no statistical significance in the levels of thyroid hormone in observation group compared to before medication （P〉0.05）. Twelve months after medication, there was no statistical significance in the levels of TT3, TT4, FT4 or TSH compared to before medi- cation （P〉0.05）; the level of FT3 was increased significantly, with statistical significance （P〈0.05）. Two cases of observation group suffered from ADR （9.1%）. Without special treatment, the symptoms all disappeared 1-2 weeks later. CONCLUSIONS： Levetiracetam can be used for pediatric epilepsy and has no significant effects on the level of sex hormone, but increases the lev- el of FT3.