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目的观察丙戊酸钠(VPA)对癫癎患儿体质量及糖、脂代谢指标的影响。方法首次诊断癫癎VPA单药治疗的患儿30例,分别于治疗前、治疗3个月和6个月进行体质量、体质量指数(BMI)、空腹血糖、血胰岛素、胰岛素抵抗(IR)指数、瘦素、脂联素和瘦素/脂联素(L/A)测定,进行治疗前后自身对照研究。结果 VPA治疗3个月患儿体质量[(21.88±1.82)kg vs(23.80±1.88)kg,P<0.001]、BMI[(15.71±0.30)kg·m-2 vs(16.40±0.27)kg·m-2,P<0.05]、血胰岛素水平[(39.81±2.70)pmol·L-1 vs(52.48±3.43)pmol·L-1,P<0.001]、IR指数[(1.42±0.13)vs(1.82±0.15),P<0.001]、瘦素水平[(3.72±0.25)mg·L-1 vs(6.73±0.72)mg·L-1,P<0.001]、L/A[(0.33±0.05)vs(0.65±0.06),P<0.001]较治疗前均明显升高,但脂联素水平[(19.02±3.09)mg·L-1vs(11.85±1.55)mg·L-1,P<0.01]较治疗前明显降低;VPA治疗6个月患儿体质量[(23.80±1.88)kg vs(25.32±2.07)kg,P<0.001]、BMI[(16.40±0.27)kg·m-2 vs(16.51±0.35)kg·m-2,P<0.05]、瘦素水平[(6.73±0.72)mg·L-1 vs(10.12±1.17)mg·L-1,P<0.001]、L/A[(0.65±0.06)vs(1.45±0.23),P<0.001]较治疗3个月时亦明显升高,而脂联素水平[(11.85±1.55)mg·L-1vs(9.00±1.13)mg·L-1,P<0.01]较治疗3个月时下降更明显;血胰岛素水平[(39.81±2.70)pmol·L-1 vs(52.48±3.43)pmol·L-1 vs(30.77±1.54)pmol·L-1,Pa<0.01]、IR指数[(1.42±0.13)vs(1.82±0.15)vs(0.99±0.06),Pa<0.01]较治疗前、治疗3个月时均明显降低。VPA治疗前后空腹血糖水平[(4.79±0.30)mmol·L-1vs(4.64±0.16)mmol·L-1vs(4.33±0.12)mmol·L-1,Pa>0.05]无显著差异。结论 VPA治疗后对癫癎患儿体质量及糖、脂代谢有一定影响。
Objective To observe the effects of valproate sodium (VPA) on body weight, glucose and lipid metabolism in children with epilepsy. Methods Thirty children with epileptic VPA were diagnosed for the first time. Body mass, body mass index (BMI), fasting blood glucose, blood insulin, insulin resistance (IR) were measured before treatment, 3 months and 6 months respectively. Index, leptin, adiponectin and leptin / adiponectin (L / A) were measured before and after treatment for self-control study. Results The body mass of children with VPA for 3 months [(21.88 ± 1.82) kg vs (23.80 ± 1.88) kg, P <0.001, and BMI 15.71 ± 0.30 kg · m -2 vs 16.40 ± 0.27 kg · (P <0.001), the IR index [(1.42 ± 0.13) vs ((P <0.05)], P <0.05] 1.82 ± 0.15), P <0.001], leptin level [(3.72 ± 0.25) mg · L -1 vs (6.73 ± 0.72) mg · L -1, P <0.001] (19.02 ± 3.09) mg · L-1vs (11.85 ± 1.55) mg · L-1, P <0.01], vs (0.65 ± 0.06, P <0.001) (P <0.001), and BMI [(16.40 ± 0.27) kg · m-2 vs (16.51 ± 0.27) kg vs (25.32 ± 2.07) kg, P < (P <0.001), L / A [(± 0.35) kg · m -2, P <0.05], leptin level [(6.73 ± 0.72) mg · L -1 vs (10.12 ± 1.17 mg · L -1, (11.85 ± 1.55) mg · L-1vs (9.00 ± 1.13) mg · L-1 (0.65 ± 0.06) vs (1.45 ± 0.23), P <0.001] -1, P <0.01], which was more obvious than that of the control group at 3 months. The level of blood insulin [(39.81 ± 2.70) pmol·L -1 vs (52.48 ± 3.43) pmol·L -1 vs 30.77 ± 1.54 pmol · L-1, Pa <0.01], IR index [(1.42 ± 0.13) vs 1.82 ± 0.15) vs (0.99 ± 0.06, Pa <0.01], which were significantly lower than those before treatment and 3 months after treatment. There was no significant difference in fasting blood glucose level before and after VPA treatment (4.79 ± 0.30 mmol·L-1 vs 4.64 ± 0.16 mmol·L-1 vs 4.33 ± 0.12 mmol·L-1, Pa> 0.05). Conclusion After VPA treatment, the body weight, glucose and lipid metabolism of epileptic children have a certain impact.