论文部分内容阅读
目的:探讨癫痫儿童服用抗癫痫药物丙戊酸钠或卡马西平后血同型半胱氨酸(homocysteine,hcy)水平的变化,以便减少其潜在风险及不利影响。方法:选取67例癫痫患儿,按使用药物分为卡马西平组与丙戊酸钠组。卡马西平和丙戊酸钠的剂量分别为10～20 mg/(kg.d)和10～40 mg/(kg.d),并依据血药浓度适度调整剂量,疗程2～5年。在用药前、用药后6个月、用药后1年监测hcy水平,比较各组hcy水平变化。结果:共有67例患儿完成本研究,丙戊酸钠组36例,卡马西平组31例。丙戊酸钠组和卡马西平组hcy在用药前分别为(6.94±2.47)μmol/L、(8.11±3.04)μmol/L,两组比较差异无统计学意义(P>0.05);6个月时分别为(7.42±2.51)μmol/L、(8.39±2.75)μmol/L,两组比较差异无统计学意义(P>0.05);1年后分别为(8.92±2.81)μmol/L、(10.45±3.98)μmol/L,两组hcy水平均较前明显升高(P<0.01)。相关分析未发现癫痫发作及抗癫痫药物浓度与hcy呈明显相关性(P>0.05)。结论:丙戊酸钠或卡马西平引起hcy水平升高,6月以后更明显,临床需注意定期监测癫痫患儿的hcy水平并适当予以干预。
Objective: To investigate the changes of blood homocysteine (hcy) levels in children with epilepsy after taking antiepileptic drug valproate or carbamazepine in order to reduce their potential risks and adverse effects. Methods: 67 children with epilepsy were selected and divided into carbamazepine group and sodium valproate group according to the drugs used. Carbamazepine and valproate sodium dose of 10 ~ 20 mg / (kg.d) and 10 ~ 40 mg / (kg.d), and based on the blood concentration of moderate dose adjustment, treatment of 2 to 5 years. Before medication, 6 months after treatment, hcy levels were monitored one year after treatment, and the levels of hcy in each group were compared. RESULTS: A total of 67 children completed the study, 36 in the valproate group and 31 in the carbamazepine group. The values of hcy in sodium valproate and carbamazepine groups before treatment were (6.94 ± 2.47) μmol / L and (8.11 ± 3.04) μmol / L respectively, with no significant difference between the two groups (P> 0.05) (7.42 ± 2.51) μmol / L and (8.39 ± 2.75) μmol / L respectively at the same month (P> 0.05), and the difference was (8.92 ± 2.81) μmol / L after one year (10.45 ± 3.98) μmol / L, both hcy levels were significantly higher than before (P <0.01). Correlation analysis did not find seizures and antiepileptic drugs concentration and hcy was significantly correlated (P> 0.05). CONCLUSIONS: Sodium valproate or carbamazepine causes elevated hcy levels, which is more evident after June. It is necessary to pay attention to regular monitoring of hcy levels in children with epilepsy and to intervene appropriately.