奥卡西平对癫痫患者免疫功能、甲状腺功能及相关因子的影响

Effect of oxcarbazepine on immune function,thyroid function and related factors in epilepsy patients

目的:探讨奥卡西平对癫痫患者免疫功能、甲状腺功能及相关因子的影响。方法:选取我院就诊的90例癫痫患者作为观察组对象,另选取90例健康志愿者作为对照组,观察组均接受奥卡西平单药治疗。检测观察组治疗前、治疗3个月后、治疗6个月后的T细胞亚群、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、总三碘甲状腺原氨酸(T_3)、总甲状腺素(T_4)、游离总三碘甲状腺原氨酸(FT_3)、游离总甲状腺素(FT_4)、促甲状腺激素(TSH)、超敏C反应蛋白(hs-CRP)与同型半胱氨酸(Hcy)水平,并与对照组进行比较。结果:对照组各时点的CD3^+、CD4^+水平高于观察组(P<0.05);对照组各时点的CD8^+、IgA、IgG水平低于观察组(P<0.05);观察组治疗3个月后、治疗6个月后的CD3^+、CD4^+水平较治疗前明显升高,差异均有统计学意义(P<0.05);观察组治疗3个月后、治疗6个月后的CD8^+、IgA、IgG水平较治疗前明显降低,差异均有统计学意义(P<0.05);观察组各时点的IgM水平与对照组相比差异不明显(P>0.05)。观察组治疗前、治疗3个月后的各甲状腺激素水平与对照组相比无统计学差异(P>0.05);观察组治疗6个月后的FT_4水平明显低于治疗前及治疗3个月后,且低于对照组,差异均有统计学意义(P<0.05);观察组各时点的T_3、T_4、FT_3、TSH水平与对照组相比差异不明显(P>0.05)。治疗前,观察组的hs-CRP、Hcy水平与对照组相比无统计学差异(P>0.05);观察组治疗3个月后的hs-CRP、Hcy水平明显高于治疗前及对照组,差异均有统计学意义(P<0.05);观察组治疗6个月后的hs-CRP、Hcy水平明显高于治疗3个月后及治疗前的水平,且高于对照组,差异均有统计学意义(P<0.05)。结论:奥卡西平可有效改善癫痫患者的免疫功能,但随着用药时间延长,可能对甲状腺功能、hs-CRP及Hcy造成不良影响。

Objective:To investigate the effects of oxcarbazepine on immune function,thyroid function and related factors in epilepsy patients.Methods:90 patients with epilepsy who visited our hospital from January 2015 to May 2018 were selected as the observation group and 90 healthy volunteers were selected as control group.All patients in the observation group were treated with oxcarbazepine alone.T lymphocyte subsets,IgA,IgG,IgM,T3,T4,FT3,FT4,TSH,hs-CRP and Hcy in observation group were detected before treatment,3 months after treatment,and 6 months after treatment.The results were compared with those of the control group.Results:The levels of CD3^+and CD4^+in the control group were(65.25±9.51)%and(43.29±6.74)%respectively,which were higher than those in the observation group(P<0.05).The levels of CD8^+,IgA and IgG in the control group were(22.40±6.41)%,(2.22±0.51)g/L,(9.99±1.28)g/L respectively,which were lower than those in the observation group(P<0.05).The levels of CD3^+and CD4^+in the observation group after 3 months and 6 months of treatment were significantly higher than those before treatment(P<0.05).The levels of CD8^+,IgA and IgG in the observation group after 3 months and 6 months of treatment were significantly lower than those before treatment(P<0.05).There was no significant difference in the level of IgM between the observation group and the control group at each time point(P>0.05).The levels of thyroid hormones in the observation group before treatment and 3 months after treatment were not significantly different from those in the control group(P>0.05).The FT4 of the observation group was(14.98±1.03)pmol/L 6 months after treatment,which was significantly lower than that of the control group before treatment and 3 months after treatment(P<0.05).The levels of T3,T4,FT3 and TSH at each time point in the observation group were not significantly different from those in the control group(P>0.05).Before treatment,there was no significant difference in hs-CRP and Hcy levels between the observation group and the control group(P>0.05).The levels of hs-CRP and Hcy in the observation group were(4.82±0.67)mg/L and(13.36±1.51)umol/L respectively after 3 months of treatment.The levels of hs-CRP and Hcy in the observation group after 3 months of treatment were significantly higher than those before treatment and in the control group,and the difference was statistically significant(P<0.05).The levels of hs-CRP and Hcy in the observation group were(4.99±0.47)mg/L and(16.83±1.94)umol/L respectively after 6 months of treatment.The levels of hs-CRP and Hcy in the observation group were significantly higher than those in the control group after 3 months of treatment and before treatment(P<0.05).Conclusion:Oxcarbazepine can effectively improve the immune function of epilepsy patients,but with the prolongation of medication time,it may have adverse effects on thyroid function,hs-CRP and Hcy.