丙戊酸钠对癫痫患儿内分泌影响的研究

Effect of Valproate on endocrine in children with epilepsy

目的 了解丙戊酸钠 (VPA)对癫痫患儿体重、内分泌激素及血脂的影响。方法 选择准备单服VPA治疗的癫痫患儿 2 4例为对照组 ;对照组癫痫患儿经治疗 3个月后为观察组 ;已单服 VPA治疗达 6个月者 2 0例为观察组 。分别检测胰岛素 (INS)、血糖 (Glu)、T3、T4 、促甲状腺素 (TSH )、总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL- C)、低密度脂蛋白胆固醇 (L DL- C)。结果 VPA治疗 3个月时体重、BMI、RWI、INS、Glu、TC、TG、L DL - C均较治疗前明显升高 (P <0 .0 5 ) ,而血糖则明显下降 (P <0 .0 5 )。T3、T4 、TSH、HDL - C与治疗前变化不明显 (P均 >0 .0 5 )。治疗 6个月后 INS、Glu、T3、T4 、TSH、TC、HDL - C的变化同治疗 3个月时 ,但 TG较治疗 3个月继续升高 ,L DL- C则下降 ,且基本恢复至治疗前水平。结论 VPA确有导致癫痫患儿肥胖的作用 ,且多在服用 VPA3个月内发生。VPA所致的肥胖与单纯性肥胖相似 ,但又不完全相同。

Objective study the effects of Valproate(VPA) on weight,endocrine and serum lipids.Methods 24 cases only with VPA in furture were included as the control group.The observation group Ⅰ was that whose patients were treated only with VPA for 3 months after been selected.While the group Ⅱ are those who have been treated with VPA for 6 months.Detection of the serum levels of INS,Glu,T 3,T 4,TSH,TC,TG,HDL-C,and LDL-C.And we compared the differences of the levels between different groups.Results When comparing the parameter's level between the initial testing and 3-month follow-up,the levels of their weight,BMI,RWI,INS,TC,TG,LDL-C in the later group were all significantly higher than those of the former one(P<0.05),while the blood glucose level decreased significantly (P<0.05).There were no significant changes in the levels of T 3,T 4,TSH,HDL-C observed.The epileptic children's INS,Glu,TC,T 3,T 4,TSH,HDL-C levels in group Ⅱ were same as levels in group Ⅰ,but TG was much more higher than that of group Ⅰ,LDL-C level was lower than that of group Ⅰ.Conclusions VPA do have the efficacy of causing obesity in the children with epilepsy,and most of the cases occurred in the first 3 months after VPA being prescribed.There are the differences between the obesity caused by VPA and simple obesity.