托吡酯与丙戊酸钠对癫痫患儿体质量糖代谢影响的临床观察-中国药房.PDF

托吡酯与丙戊酸钠对癫痫患儿体质量、糖代谢影响的临床观察 ＊ 叶静萍 （武汉大学人民医院儿科，武汉 430060） 中图分类号 R742.1 文献标志码 A 文章编号 1001-0408（2015）06-0740-03 DOI 10.6039/j.issn. 1001-0408.2015.06.08 摘 要 目的：观察托吡酯与丙戊酸钠对癫痫患儿体质量、糖代谢的影响。方法：选取72例癫痫患儿随机均分为研究A 组和研究 B 组，另选取40例健康儿童作为对照组。研究A 组服用托吡酯片，初始剂量为0.5～1mg/（kg ·d），逐渐加至最大剂量3mg/（kg ·d ）；研究 B 组服用丙戊酸钠糖浆，初始剂量为15mg/ （kg ·d ）丙戊酸钠糖浆，逐渐加至最大剂量30mg/ （kg ·d ）。两组患儿观察时段均为6个 月。比较两组患儿和对照组健康儿童治疗前后的体质量和糖代谢指标。结果：治疗6个月后，研究A 组患儿体质量和体质量指数 （BMI ）显著低于研究B 组、对照组，而研究B 组患儿体质量和BMI 显著高于对照组，差异均有统计学意义（P ＜0.05）。研究A 组患 儿脂联素显著高于研究B 组、对照组，血清瘦素、胰岛素、胰岛素抵抗（IR ）指数显著低于研究B 组、对照组；而研究B 组患儿脂联素 显著低于对照组，血清瘦素、胰岛素、IR 指数显著高于对照组，差异均有统计学意义（P ＜0.05）。结论：托吡酯治疗后癫痫患儿体质 量增长显著减缓，丙戊酸钠治疗后癫痫患儿体质量增长则显著加快，且两种药物均可使癫痫患儿的糖代谢指标出现不同程度的下 降或者升高。故建议临床应当合理应用抗癫痫药物，最大限度地降低药物副作用的影响，确保患儿的正常生长发育。 关键词 儿童；癫痫；托吡酯；丙戊酸钠；体质量；糖代谢 Clinical Observation of the Effects of Topiramate and Sodium Valproate on Body Weight and Glucose Metabo- lism in Epileptic Children YE Jing-ping （Dept. of Paediatrics ，Wuhan University People ’s Hospital ，Wuhan 430060，China ） ABSTRACT OBJECTIVE ：To observe the effects of topiramate and sodium valproate on body weight and glucose metabolism in epileptic children. METHODS ：72 epileptic children were randomly divided into research group A and research group B ；other 40 healthy children were included in control group. Research group A were given Topiramate tablets with initial dose of 0.5-1mg/（kg·d ）， increasing to maximal dose of 3mg/ （kg ·d ）gradually. Research group B were treated with Sodium valproate syrup with initial dose of 15 mg/ （kg ·d ），increasing to maximal dose of 3 mg/ （kg ·d ）gradually. Both groups were observed for 6 months. The body weight index （BMI ）and glucose metabolism index of 2 groups were compared with control group before and after treatment. RE- SULTS ：After 6 months of treatment ，body weight and BMI of research group A were significantly lower than those of research group B