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目的 探讨卡马西平 (CBZ)对癫痫患儿甲状腺激素水平的影响。方法 对 2 7例初诊为癫痫患儿行CBZ单药治疗前、平均治疗 3个月后及 2 5例长期行CBZ单药治疗平均 1年 7个月后的癫痫患儿 ,用放射免疫法分别测定血清甲状腺素 (T4 )、游离T4 (FT4 )、三碘甲腺原氨酸 (T3)、游离T3(FT3)及促甲状腺激素 (TSH)的水平 ,并以 32例健康儿童作为对照。结果 CBZ平均治疗 3月后T4 、FT4 分别为 (113 1± 40 6 )nmol/L和 (16 6± 3 6 )pmol/L ,均明显低于治疗前的 (138 2± 35 6 )nmol/L(P <0 0 1)和 (2 0 5± 4 5 ) pmol/L(P <0 0 1)。长期服用CBZ平均 1年 7个月的患儿与健康对照组相比 ,T4 、FT4 水平同样降低 ,分别为 (10 8 9± 44 6 )nmol/L(P <0 0 5 )和 (15 5± 3 7) pmol/L(P <0 0 0 1)。结论 甲状腺激素水平的改变与CBZ的肝酶诱导作用有关 ,提示CBZ治疗期间监测患儿甲状腺功能的必要性
Objective To investigate the effect of carbamazepine (CBZ) on thyroid hormone in children with epilepsy. Methods Twenty-seven children with epilepsy who were newly diagnosed as epilepsy were treated with CBZ monotherapy, and the mean treatment was 3 months later. Twenty-five children with epilepsy were treated with CBZ monotherapy for an average of 1 year and 7 months. Radioimmunoassay The levels of serum T4, FT4, T3, FT3 and TSH were measured and 32 healthy children were taken as control. Results After CBZ treatment for 3 months, the levels of T4 and FT4 were (113 1 ± 40 6) nmol / L and (16 6 ± 3 6) pmol / L respectively, both significantly lower than those before treatment (138 2 ± 35 6 nmol / L (P <0 0 1) and (2 0 5 ± 4 5) pmol / L (P 0 01). Compared with the healthy control group, the levels of T4 and FT4 in children who took CBZ for an average of 1 year and 7 months were also decreased (10 8 9 ± 44 6) nmol / L (P 5 05) and (15 5 ± 3 7) pmol / L (P <0 0 0 1). Conclusions The change of thyroid hormone levels is related to the induction of hepatic enzymes in CBZ, suggesting the necessity of monitoring thyroid function in children with CBZ