癫癇患儿托吡酯治疗前后甲状腺激素水平的检测及分析

The study on the effect of topiramate(TPM) on serum levels of thyroid hormones in epileptic children

目的 探讨托吡酯 (TPM )对癫疒间 患儿甲状腺激素水平的影响。方法 对 5 1例癫疒间 患儿用托吡酯进行单药治疗 ,在治疗前及治疗 6个月后用放射免疫法分别测定其血清甲状腺素 (T4)、游离T4(FT4)、三碘甲状腺原氨酸 (T3 )、游离T3 (FT3 )、3,3,5三碘甲状腺原氨酸 (rT3 )及促甲状腺素 (TSH)的水平 ,并进行前后比较。结果 在托吡酯治疗前T4、FT4、T3 、FT3 、rT3 、TSH分别为 (12 4 0 85± 2 3 348)nmol/L、(17 4 89± 3 96 5 ) pmol/L、(1 6 6 3± 0 2 97)nmol/L、(5 82 5± 1 82 ) pmol/L、(1 12 4± 0 2 16 )nmol/L、(4 5 99± 1 317) μIU/mL。用托吡酯治疗后T4、FT4、T3 、FT3 、rT3 、TSH分别为 (12 3 2 0 1± 2 5 15 5 )nmol/L、(18 5 0 2± 3 5 4 3) pmol/L、(1 5 98± 0 35 6 )nmol/L、(6 4 4 4± 1 86 5 ) pmol/L、(1 315± 0 195 )nmol/L、(4 4 74± 1 331) μIU/mL ,T4、FT4、FT3 、TSH治疗前后比较无显著性差异 (P >0 0 5 )。T3 治疗后较治疗前显著降低 (P <0 0 5 ,t=3 12 5 ) ,而rT3 治疗后较治疗前升高 (P <0 0 5 )。结论 托吡酯治疗时有降低癫疒间 患儿血清中T3 的作用 ,提示在使用托吡酯治疗时应定期监测甲状腺功能。

Objective To study the effect of TPM on thyroid hormones in epileptic children.Methods 51 children who were diagnosed as having epilepsy according to the diagnostic criteria of classification of the International Anti epilepsia League (1985) were treated with TPM alone.T 4,FT 4,T 3,FT 3,rT 3 and TSH levels were determined by RIA before and 6 months after treatment with TPM,and then compared.Results T 4,FT 4, T 3,FT 3,rT 3 and TSH levels before and 6 months after treatment with TPM were (124 085±23 348)nmol/L and (17 489±3 965)pmol/L,(1 663±0 297)nmol/L,(5 825±1 82)pmol/L,(1 124±0 216)nmol/L and (4 599±1 317)μIU/mL vs (123 201±25 155)nmol/L,(18 502±3 543)pmol/L,(1 598±0 356)nmol/L,(6 444±1 865)pmol/L,(1 315±0 195)nmol/L,and (4 474±1 331)μIU/mL,respectively.There was no significant difference in T 4,FT 4,FT 3 and TSH before and after treatment (P>0 05,);after treatment T 3 was significantly lower than that before treatment (P<0 05,t=3 125) and rT 3 was significantly higher than that before treatment (P<0 05).Conclusion TPM has the action of lowering serum T 3 in treating epileptic children,indicating that when TPM is used for treatment,the thyroid function should be monitored regularly.