丙戊酸钠治疗成人癫痫合并非酒精性脂肪性肝病的临床研究进展

Progress of Clinical Studies on the Use of Sodium Valproate in Adult Patients with Epilepsy Combined with Nonalcoholic Fatty Liver Disease

癫痫患者易发生肥胖和代谢综合征,其风险高于一般人群,非酒精性脂肪性肝病(NAFLD)是代谢综合征的一种表现,以肝脂肪变性为主要特征,在一定程度上可加重癫痫患者病情。丙戊酸钠作为临床常用抗癫痫药物,可导致肝细胞内三酰甘油蓄积,诱发NAFLD风险。对于成人癫痫合并NAFLD患者,使用丙戊酸钠治疗,会使已经受脂肪变性影响的肝脏更易引起损伤,影响丙戊酸钠代谢。丙戊酸钠和NAFLD均可诱导肝脏脂肪变性,在癫痫治疗过程中可加重彼此诱导的肝脂肪变性,具有协同作用。该文就丙戊酸钠应用于成人癫痫合并NAFLD患者的临床研究进展进行综述,以期为相关研究提供参考。

Epilepsy patients are prone to obesity and metabolic syndrome(MetS),which is a higher risk than the general population.Nonalcoholic fatty liver disease(NAFLD)is a manifestation of a metabolic syndrome,characterized by hepatic steatosis,which can be exacerbated to some extent in patients with epilepsy.Sodium valproate(VPA),a commonly used clinical antiepileptic drug,leads to triglyceride accumulation in liver cells and induces a risk of NAFLD.In adults with epilepsy combined with NAFLD,treatment with VPA can make the liver,which is already affected by steatosis,more sensitive to VPA-induced liver injury and affect VPA drug metabolism.Both VPA and NAFLD induce hepatic steatosis,and can exacerbate each other's induced hepatic steatosis synergistically during epilepsy treatment.In this paper,we reviewed the progress of clinical studies on the use of VPA in adult patients with epilepsy combined with NAFLD to provide references for effective treatment and future studies of VPA.