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目的:研究服用托吡酯、丙戊酸的癫病人的体重变化是否与胰岛素和瘦素水平的变化有关。方法:用放射免疫方法检测142例癫病人的空腹胰岛素和瘦素水平。结果:①托吡酯组(55例)与对照组(35例)比:托吡酯组空腹胰岛素水平低于对照组(P=0·025),尤其是女性病人(P=0·040);两组空腹瘦素水平的差异无显著性(P=0·420),但男性的空腹瘦素水平均低于女性(对照组P=0·001,托吡酯组P=0·022)。②丙戊酸组(24例)与对照组(28例)比:两组空腹胰岛素水平的差异无显著性(P=0·368),但丙戊酸组肥胖病人的空腹胰岛素水平高于非肥胖病人(P=0·032);丙戊酸组空腹瘦素水平高于对照组(P=0·017),尤其是肥胖病人(P=0·011);丙戊酸组肥胖病人的空腹瘦素水平高于非肥胖病人(P=0·037)。结论:托吡酯可显著降低非肥胖女性癫病人的空腹胰岛素水平,对瘦素水平无显著性影响。丙戊酸对癫病人空腹胰岛素水平无明显影响;可显著增加癫病人的空腹瘦素水平,尤其是肥胖病人。
OBJECTIVE: To investigate whether changes in body weight of epileptic patients taking topiramate and valproic acid are associated with changes in insulin and leptin levels. Methods: Radioimmunoassay was used to detect fasting insulin and leptin levels in 142 epileptic patients. Results: ① Topiramate group (55 cases) compared with control group (35 cases): the fasting insulin level in topiramate group was lower than that in control group (P = 0 · 025), especially in female patients (P = 0 · 040) There was no significant difference in leptin levels (P = 0.204). However, the fasting leptin level in males was lower than that in females (P = 0.001 for the control group and P = 0.022 for the topiramate group). The ratio of valproic acid group (24 cases) to control group (28 cases): There was no significant difference in fasting insulin level between the two groups (P = 0.368), but the fasting insulin level of obese patients in valproic acid group was higher than that of non-valproic acid group Obese patients (P = 0.032); the fasting leptin level in valproic acid group was higher than that in control group (P = 0.017), especially in obese patients (P = 0.011) Leptin levels were higher in non-obese patients (P = 0 · 037). Conclusion: Topiramate can significantly reduce the fasting insulin level in non-obese female epilepsy patients and have no significant effect on leptin level. Valproic acid had no significant effect on the fasting insulin level in patients with epilepsy; it could significantly increase the fasting leptin level in patients with epilepsy, especially in obese patients.