酮体在生酮饮食治疗癫痫中的研究进展

Research progress of ketone bodies in ketogenic diet therapy of epilepsy

生酮饮食疗法是一种脂肪高比例、碳水化合物低比例、蛋白质和其他营养素合适的配方饮食,主要用于儿童难治性癫痫的治疗。生酮饮食疗法治疗期间体内的主要代谢变化是产生大量酮体,酮体不仅可以供能,而且对脑内异常兴奋信号传递的抑制起重要作用。但酮体在生酮饮食疗法抗癫痫作用的机制目前仍不十分清楚,部分临床研究发现血酮水平与癫痫控制效果不一致。现从生酮饮食疗法中酮体的合成、监测、有效浓度范围及其与疗效的关系等几个方面的最新研究进展进行综述,以期为临床开展生酮饮食时血酮水平的控制提供参考。

Ketogenic dietary therapy(KDT)is a kind of formulated diet with high fat,low carbohydrates,and appropriate protein and other nutrients,which is mainly used for the treatment of intractable epilepsy in children.The main metabolic change in the body during KDT is the production of a large number of ketone bodies which can not only provide energy,but also plays an important role in inhibiting the transmission of abnormal excitatory signals in the brain.However,the anti-epileptic mechanism of ketone bodies in KDT is still not very clear.Some clinical studies have found that the level of blood ketone is inconsistent with the effect of epilepsy control.The latest progress of research on the synthesis,monitoring,effective concentration range and the relationship with efficacy of ketone bodies in ketogenic diet therapy are reviewed in this article,in order to provide reference blood ketone range in clinical ketogenic diet.