BACKGROUND: It has been demonstrated that traditional antiepileptics, such as phenytoin, carbamazepine (CBZ), phenobarbital, etc., can result in the decrease of thyroid hormone of epileptic patients. However, there is...BACKGROUND: It has been demonstrated that traditional antiepileptics, such as phenytoin, carbamazepine (CBZ), phenobarbital, etc., can result in the decrease of thyroid hormone of epileptic patients. However, there is still no sufficient evidence for the studies about the effect of new-type antiepileptics, such as topiramate (TPM), on thyroid hormones. OBJECTIVE: To observe the effects of TPM and CBZ on the level of thyroid hormones in serum of adults with epilepsy. DESIGN: A comparative observation. SETTING: Department of Neurology, Sichuan Provincial People's Hospital. PARTICIPANTS: Totally 100 outpatients or inpatients newly diagnosed to have epilepsy were selected from the Department of Neurology, Sichuan Provincial People's Hospital from July 2003 to August 2005, including 60 males and 40 females, aged 18-70 years. All the patients were accorded with the standard for the classification of epilepsy set by International League Against Epilepsy (ILAE) in 1981; Had been Informed and agreed with the detection; Had no history of thyroid gland disease; Had not taken any drugs could affect the thyroid function. Meanwhile, 40 adult healthy examinees were selected from our hospital as the control group, including 24 males and 16 females, aged 18-65 years. METHODS: ① The 100 epileptic patients were randomly divided into TPM group (n =50) and CBZ group (n =50), and they were treated with TPM (Xian-Janssen Pharmaceutical, Ltd.; Batch number: 03AS032, Norm: 25 mg/tablet) and CBZ (Shanghai Sunve Pharmaceutical Co., Ltd.; Batch number: 030201, Norm: 100 mg/tablet) respectively. The initial dosage of TPM was 25 mg per day, increased by 25 mg every week, the objective dosage of 100-200 mg per day was maintained when the symptoms were satisfactorily controlled. The dosage of CBZ was 6-8 mg/kg per day. All the patients were administrated for 1 year. ② The serum levels of total thyroxine (TT4), free thyroxine (FT4), total triiodothyronine (TT3), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) in the epileptic patients were detected by means of chemiluminescence before treatment and at 3, 6 and 12 months after treatment respectively. ③Standards for judging curative effects: Controlled by without seizure, the frequency of seizure reduced by ≥ 75% was taken as significant effect, reduced by 50%-74% as effect, and reduced by < 49% as invalid, whereas increased by more than 20% was taken as aggravation. ④ The intergroup and intragroup differences of the measurement data were compared by the analysis of variance and paired t test respectively. MAIN OUTCOME MEASURES: Serum levels of thyroid hormones before treatment and at different time points after treatment of TPM and CBZ. RESULTS: All the 100 epileptic patients and 40 healthy subjects were involved in the analysis of results. ① Changes of serum levels of thyroid hormones: The serum levels of TT3, TT4, FT3, FT4 and TSH were close between the epileptic patients and normal subjects before treatment (P > 0.05). In the CBZ group, the serum levels of FT4 at 3, 6 and 12 months after treatment [(16.87±3.77), (16.34±3.98) , (16.97±3.95) pmol/L] were significantly decreased as compared with those before treatment [(18.00±3.54) pmol/L, t =2.74, 3.50, 2.26, P < 0.05]; The levels of TT3 at 3, 6 and 12 months [(2.09±0.54), (1.99±0.49), (1.84±0.47) nmol/L] were significantly decreased as compared with those before treatment [(2.22±0.63) nmol/L, t =2.73, 2.78, 5.18, P < 0.05]. The levels of TT3 at 6 and 12 months [(109.65±23.98), (107.72±23.90) nmol/L] were significantly decreased as compared with those before treatment [(118.98±28.48) nmol/L, t =3.11, 3.30, P < 0.05]. TT4 level in serum at 3 months and the levels of FT3 and TSH at each time point after CBZ treatment had no obvious changes as compared with those before treatment (P > 0.05). In the TPM group, the levels of thyroid hormones at each time point had no obvious changes as compared with those before treatment (P > 0.05). ② Curative effects: Of the 100 epileptic patients, it was controlled in 12 cases, significantly effective in 30 cases, effective in 39 cases and invalid in 19 cases, the total effective rate was 81% (81/100). CONCLUSION: CBZ treatment can lead to the decreases of thyroid hormones in adult epileptic patients. Epilepsy itself and TPM treatment cannot change the thyroid hormones in adult epileptic patients, which suggests that TPM treatment is safer for the thyroid function of adult epileptic patients.展开更多
Objective: To investigate the effects of oxcarbazepine on immune function, thyroid function and related factors in epilepsy patients. Method: 90 patients with epilepsy who visited our hospital from January 2015 to May...Objective: To investigate the effects of oxcarbazepine on immune function, thyroid function and related factors in epilepsy patients. Method: 90 patients with epilepsy who visited our hospital from January 2015 to May 2018 were selected as the observation group and 90 healthy volunteers were selected as control group. All patients in the observation group were treated with oxcarbazepine alone. T lymphocyte subsets, IgA, IgG, IgM, T3, T4, FT3, FT4, TSH, hs-CRP and Hcy in observation group were detected before treatment, 3 months after treatment and 6 months after treatment. The results were compared with those of the control group. Results: The levels of CD3+ and CD4+ in the control group were (65.25±9.51)% and (43.29±6.74)% respectively, which were higher than those in the observation group (P<0.05). The levels of CD8+, IgA and IgG in the control group were (22.40±6.41)%, (2.22±0.51) g/L, (9.99±1.28) g/L respectively, which were lower than those in the observation group (P<0.05). The levels of CD3+ and CD4+ in the observation group after 3 months and 6 months of treatment were significantly higher than those before treatment (P<0.05). The levels of CD8+, IgA and IgG in the observation group after 3 months and 6 months of treatment were significantly lower than those before treatment (P<0.05). There was no significant difference in the level of IgM between the observation group and the control group at each time point (P>0.05). The levels of thyroid hormones in the observation group before treatment and 3 months after treatment were not significantly different from those in the control group (P>0.05). The FT4 of the observation group was (14.98±1.03) pmol/L 6 months after treatment, which was significantly lower than that of the control group before treatment and 3 months after treatment (P<0.05). The levels of T3, T4, FT3 and TSH at each time point in the observation group were not significantly different from those in the control group (P>0.05). Before treatment, there was no significant difference in hs-CRP and Hcy levels between the observation group and the control group (P>0.05). The levels of hs-CRP and Hcy in the observation group were (4.82±0.67) mg/L and (13.36±1.51) umol/L respectively after 3 months of treatment. The levels of hs-CRP and Hcy in the observation group after 3 months of treatment were significantly higher than those before treatment and in the control group, and the difference was statistically significant (P<0.05). The levels of hs-CRP and Hcy in the observation group were (4.99±0.47) mg/L and (16.83±1.94) umol/L respectively after 6 months of treatment. The levels of hs-CRP and Hcy in the observation group were significantly higher than those in the control group after 3 months of treatment and before treatment (P<0.05). Conclusion: Oxcarbazepine can effectively improve the immune function of epilepsy patients, but with the prolongation of medication time, it may have adverse effects on thyroid function, hs-CRP and Hcy.展开更多
Objective:To explore the effect of sodium valproate retard tablet on the oxidative stress system, cognitive function, and thyroid hormone level in patients with epilepsy.Methods:A total of 68 patients with epilepsy we...Objective:To explore the effect of sodium valproate retard tablet on the oxidative stress system, cognitive function, and thyroid hormone level in patients with epilepsy.Methods:A total of 68 patients with epilepsy were included in the study and randomized into the treatment group and the control group with 34 cases in each group. The patients in the treatment group were given sodium valproate retard tablets, while the patients in the control group were given carbamazepine. The patients in the two groups were treated continuously for 6 months. The oxidative stress indicators and thyroid hormone level before and after treatment in the two groups were detected and compared. MMSE was used to evaluate the cognitive function in the two groups.Results: MPO, SOD, CAT, and GSH-Px levels after treatment in the two groups were significantly reduced when compared with before treatment, while MDA level was significantly elevated. The improvement of the above indicators after treatment in the treatment group was significantly superior to that in the control group. FT3 and FT4 levels after treatment in the control group were significantly reduced when compared with before treatment, but were significantly lower than those in the treatment group. MMSE score 3 and 6 months after treatment in the two groups was significantly elevated when compared with before treatment. MMSE score at each timing point after treatment in the treatment group was significantly higher than that in the control group.Conclusions: The sodium valproate has a small effect on the balance of oxidation and anti-oxidation in patients with epilepsy, and can significantly improve the cognitive function.展开更多
文摘BACKGROUND: It has been demonstrated that traditional antiepileptics, such as phenytoin, carbamazepine (CBZ), phenobarbital, etc., can result in the decrease of thyroid hormone of epileptic patients. However, there is still no sufficient evidence for the studies about the effect of new-type antiepileptics, such as topiramate (TPM), on thyroid hormones. OBJECTIVE: To observe the effects of TPM and CBZ on the level of thyroid hormones in serum of adults with epilepsy. DESIGN: A comparative observation. SETTING: Department of Neurology, Sichuan Provincial People's Hospital. PARTICIPANTS: Totally 100 outpatients or inpatients newly diagnosed to have epilepsy were selected from the Department of Neurology, Sichuan Provincial People's Hospital from July 2003 to August 2005, including 60 males and 40 females, aged 18-70 years. All the patients were accorded with the standard for the classification of epilepsy set by International League Against Epilepsy (ILAE) in 1981; Had been Informed and agreed with the detection; Had no history of thyroid gland disease; Had not taken any drugs could affect the thyroid function. Meanwhile, 40 adult healthy examinees were selected from our hospital as the control group, including 24 males and 16 females, aged 18-65 years. METHODS: ① The 100 epileptic patients were randomly divided into TPM group (n =50) and CBZ group (n =50), and they were treated with TPM (Xian-Janssen Pharmaceutical, Ltd.; Batch number: 03AS032, Norm: 25 mg/tablet) and CBZ (Shanghai Sunve Pharmaceutical Co., Ltd.; Batch number: 030201, Norm: 100 mg/tablet) respectively. The initial dosage of TPM was 25 mg per day, increased by 25 mg every week, the objective dosage of 100-200 mg per day was maintained when the symptoms were satisfactorily controlled. The dosage of CBZ was 6-8 mg/kg per day. All the patients were administrated for 1 year. ② The serum levels of total thyroxine (TT4), free thyroxine (FT4), total triiodothyronine (TT3), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) in the epileptic patients were detected by means of chemiluminescence before treatment and at 3, 6 and 12 months after treatment respectively. ③Standards for judging curative effects: Controlled by without seizure, the frequency of seizure reduced by ≥ 75% was taken as significant effect, reduced by 50%-74% as effect, and reduced by < 49% as invalid, whereas increased by more than 20% was taken as aggravation. ④ The intergroup and intragroup differences of the measurement data were compared by the analysis of variance and paired t test respectively. MAIN OUTCOME MEASURES: Serum levels of thyroid hormones before treatment and at different time points after treatment of TPM and CBZ. RESULTS: All the 100 epileptic patients and 40 healthy subjects were involved in the analysis of results. ① Changes of serum levels of thyroid hormones: The serum levels of TT3, TT4, FT3, FT4 and TSH were close between the epileptic patients and normal subjects before treatment (P > 0.05). In the CBZ group, the serum levels of FT4 at 3, 6 and 12 months after treatment [(16.87±3.77), (16.34±3.98) , (16.97±3.95) pmol/L] were significantly decreased as compared with those before treatment [(18.00±3.54) pmol/L, t =2.74, 3.50, 2.26, P < 0.05]; The levels of TT3 at 3, 6 and 12 months [(2.09±0.54), (1.99±0.49), (1.84±0.47) nmol/L] were significantly decreased as compared with those before treatment [(2.22±0.63) nmol/L, t =2.73, 2.78, 5.18, P < 0.05]. The levels of TT3 at 6 and 12 months [(109.65±23.98), (107.72±23.90) nmol/L] were significantly decreased as compared with those before treatment [(118.98±28.48) nmol/L, t =3.11, 3.30, P < 0.05]. TT4 level in serum at 3 months and the levels of FT3 and TSH at each time point after CBZ treatment had no obvious changes as compared with those before treatment (P > 0.05). In the TPM group, the levels of thyroid hormones at each time point had no obvious changes as compared with those before treatment (P > 0.05). ② Curative effects: Of the 100 epileptic patients, it was controlled in 12 cases, significantly effective in 30 cases, effective in 39 cases and invalid in 19 cases, the total effective rate was 81% (81/100). CONCLUSION: CBZ treatment can lead to the decreases of thyroid hormones in adult epileptic patients. Epilepsy itself and TPM treatment cannot change the thyroid hormones in adult epileptic patients, which suggests that TPM treatment is safer for the thyroid function of adult epileptic patients.
文摘Objective: To investigate the effects of oxcarbazepine on immune function, thyroid function and related factors in epilepsy patients. Method: 90 patients with epilepsy who visited our hospital from January 2015 to May 2018 were selected as the observation group and 90 healthy volunteers were selected as control group. All patients in the observation group were treated with oxcarbazepine alone. T lymphocyte subsets, IgA, IgG, IgM, T3, T4, FT3, FT4, TSH, hs-CRP and Hcy in observation group were detected before treatment, 3 months after treatment and 6 months after treatment. The results were compared with those of the control group. Results: The levels of CD3+ and CD4+ in the control group were (65.25±9.51)% and (43.29±6.74)% respectively, which were higher than those in the observation group (P<0.05). The levels of CD8+, IgA and IgG in the control group were (22.40±6.41)%, (2.22±0.51) g/L, (9.99±1.28) g/L respectively, which were lower than those in the observation group (P<0.05). The levels of CD3+ and CD4+ in the observation group after 3 months and 6 months of treatment were significantly higher than those before treatment (P<0.05). The levels of CD8+, IgA and IgG in the observation group after 3 months and 6 months of treatment were significantly lower than those before treatment (P<0.05). There was no significant difference in the level of IgM between the observation group and the control group at each time point (P>0.05). The levels of thyroid hormones in the observation group before treatment and 3 months after treatment were not significantly different from those in the control group (P>0.05). The FT4 of the observation group was (14.98±1.03) pmol/L 6 months after treatment, which was significantly lower than that of the control group before treatment and 3 months after treatment (P<0.05). The levels of T3, T4, FT3 and TSH at each time point in the observation group were not significantly different from those in the control group (P>0.05). Before treatment, there was no significant difference in hs-CRP and Hcy levels between the observation group and the control group (P>0.05). The levels of hs-CRP and Hcy in the observation group were (4.82±0.67) mg/L and (13.36±1.51) umol/L respectively after 3 months of treatment. The levels of hs-CRP and Hcy in the observation group after 3 months of treatment were significantly higher than those before treatment and in the control group, and the difference was statistically significant (P<0.05). The levels of hs-CRP and Hcy in the observation group were (4.99±0.47) mg/L and (16.83±1.94) umol/L respectively after 6 months of treatment. The levels of hs-CRP and Hcy in the observation group were significantly higher than those in the control group after 3 months of treatment and before treatment (P<0.05). Conclusion: Oxcarbazepine can effectively improve the immune function of epilepsy patients, but with the prolongation of medication time, it may have adverse effects on thyroid function, hs-CRP and Hcy.
文摘Objective:To explore the effect of sodium valproate retard tablet on the oxidative stress system, cognitive function, and thyroid hormone level in patients with epilepsy.Methods:A total of 68 patients with epilepsy were included in the study and randomized into the treatment group and the control group with 34 cases in each group. The patients in the treatment group were given sodium valproate retard tablets, while the patients in the control group were given carbamazepine. The patients in the two groups were treated continuously for 6 months. The oxidative stress indicators and thyroid hormone level before and after treatment in the two groups were detected and compared. MMSE was used to evaluate the cognitive function in the two groups.Results: MPO, SOD, CAT, and GSH-Px levels after treatment in the two groups were significantly reduced when compared with before treatment, while MDA level was significantly elevated. The improvement of the above indicators after treatment in the treatment group was significantly superior to that in the control group. FT3 and FT4 levels after treatment in the control group were significantly reduced when compared with before treatment, but were significantly lower than those in the treatment group. MMSE score 3 and 6 months after treatment in the two groups was significantly elevated when compared with before treatment. MMSE score at each timing point after treatment in the treatment group was significantly higher than that in the control group.Conclusions: The sodium valproate has a small effect on the balance of oxidation and anti-oxidation in patients with epilepsy, and can significantly improve the cognitive function.
