左乙拉西坦对癫痫患儿用药一年时骨代谢及甲状腺激素水平的影响

The effects of levetiracetam on bone metabolism and thyroid hormone levels in children with epilepsy for one year

目的探讨左乙拉西坦(levetiracetam,LEV)对癫痫患儿骨代谢及甲状腺激素水平的影响。方法选取我院2016年7月至2017年6月神经内科门诊及住院部首发初诊的癫痫患儿20例为治疗组,另取同期来本院接受健康体检的儿童20例为对照组。治疗组给予LEV单药治疗满12个月。记录对照组及治疗组用药前、用药后6及12个月的各项骨代谢指标(血钙、血磷、血碱性磷酸酶、骨钙素、甲状旁腺素、25-羟维生素D)、骨密度(bone mineral density,BMD)及血清甲状腺激素(三碘甲状腺原氨酸、甲状腺素、游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺激素)水平变化,并进行比较。结果(1)对照组及治疗组用药前各种骨代谢指标及BMD比较,差异均无统计学意义(P>0.05);治疗组治疗前、治疗后6及12个月各种骨代谢指标及BMD相比较,差异无统计学意义(P>0.05)。(2)对照组及治疗组用药前甲状腺激素水平相比差异无统计学意义(P>0.05);治疗后6、12个月,治疗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)。结论LEV治疗1年时对癫痫患儿的骨代谢、甲状腺激素水平无明显影响。

Objective To investigate the effects of levetiracetam on bone metabolism and thyroid hormone levels in children with epilepsy.Methods A total of 20 children with epilepsy first diagnosed in our hospital from July 2016 to June 2017 were selected as the treatment group,the other 20 children who received physical examination in the same period were selected as the control group.The treatment group was given oral LEV monotherapy for 12 months.The changes of bone metabolism indexes[blood calcium,blood phosphorus,alkaline phosphatase activities,osteocalcin,parathyroid hormone,25-(OH)D],bone mineral density(BMD)and serum thyroid hormone(triiodothyronine,tetraiodothyronine,free triiodothyronine,free thyroxine,thyroid stimulating hormone)in the control group and the treatment group were detected before,6 and 12 months after medication.Results(1)There were no statistically significant differences in bone metabolism indexes and BMD between the control group and the treatment group before medication(P>0.05).The differences showed no statistically significant in bone metabolism indexes and BMD among different time points of treatment group(P>0.05).(2)There were no significant differences in thyroid hormone levels between the control group and the treatment group before medication(P>0.05).There were no significant differences in thyroid hormone levels among different time points of treatment group(P>0.05).Conclusion Levetiracetam has no significant effects on bone metabolism and thyroid hormone level in epileptic children.