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目的:通过对服用丙戊酸钠(VPA)的癫痫患儿肝功能和血脂的变化的观察,并对其影响因素进行分析,指导在临床工作中合理用药。方法:对54例不同年龄癫痫患儿分别比较服药前和服药3个月后的体质量指数(BMI)、瘦素、胰岛素、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的水平。结果:VPA治疗3个月后BMI、瘦素、胰岛素、HOMA指数、TC、TG、LDL-C均较治疗前明显升高(P<0.05),而血糖则明显下降(P<0.05)。结论:VPA确有导致癫痫患儿肥胖的作用,且多在服用VPA3个月内发生。VPA所致的肥胖与单纯性肥胖相似,但又不完全相同。对需要长期接受丙戊酸钠治疗的癫痫患儿,对其血脂监测的意义在于动态比较分析,而不该局限于该值是否正常。
Objective: To observe the changes of liver function and blood lipids in children with epilepsy induced by valproate (VPA), and to analyze the influencing factors, so as to guide the rational use of drugs in clinical work. Methods: Fifty-four children with epilepsy of different ages were compared before and 3 months after taking the drug. The body mass index (BMI), leptin, insulin, triglyceride (TG), total cholesterol (TC), high density lipoprotein Cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) levels. Results: The BMI, leptin, insulin, HOMA index, TC, TG and LDL-C in VPA group were significantly higher than those before VPA treatment (P <0.05), while the blood glucose was significantly decreased (P <0.05). Conclusions: VPA does have a role in obesity in children with epilepsy and occurs more frequently within 3 months of taking VPA. VPA caused by obesity and simple obesity is similar, but not exactly the same. The need for long-term treatment of epilepsy sodium valproate in children, the significance of its lipid monitoring is the dynamic comparative analysis, but should not be limited to the value of the normal.