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目的探讨托吡酯治疗癫痫患儿的临床疗效,并分析托吡酯对癫痫患儿血糖、胰岛素、皮质醇、瘦素、胃饥饿素和神经肽Y水平及对患儿体重指数的影响。方法回顾性分析2011年10月—2013年10月间在浙江省人民医院儿科进行治疗的20例癫痫患儿病例资料。所有患儿均给予5 mg/(kg·d)托吡酯进行治疗,于治疗前、治疗后3个月和6个月时测定患儿空腹血糖、胰岛素、血清瘦素、神经肽Y、胃饥饿素、皮质醇的水平和患儿体重指数。结果治疗3个月时,患儿胰岛素水平、身体质量指数(BMI)分别为(4.65±2.28)μU/ml和(15.87±1.90)kg/m~2,均显著低于治疗前的(5.83±2.72)μU/ml和(16.44±1.84)kg/m~2(P<0.05);而治疗6个月时,胰岛素水平比治疗3个月时升高,且与治疗前比较差异无统计学意义(P>0.05)。治疗6个月时,患儿血清皮质醇和瘦素水平分别为(10.13±4.17)μg/dl和(2.14±2.03)ng/ml,显著低于治疗前的[(13.25±5.50)μg/dl和(2.89±2.63)ng/ml](P<0.05);治疗前后,患儿的血糖、胃饥饿素和神经肽Y水平无显著性变化(P>0.05)。结论托吡酯治疗癫痫患儿,血清瘦素、皮质醇水平降低,这可能是托吡酯治疗导致癫痫患儿身体质量指数水平下降的重要原因。
Objective To investigate the clinical efficacy of topiramate in children with epilepsy and to analyze the effects of topiramate on blood glucose, insulin, cortisol, leptin, ghrelin and neuropeptide Y in children with epilepsy and the body mass index in children with epilepsy. Methods The data of 20 cases of children with epilepsy treated in Pediatrics of Zhejiang Provincial People’s Hospital from October 2011 to October 2013 were retrospectively analyzed. All children were given topiramate 5 mg / (kg · d) for treatment. Before and 3 months and 6 months after treatment, the fasting blood glucose, insulin, serum leptin, neuropeptide Y, ghrelin , The level of cortisol and children with body mass index. Results At 3 months, the insulin level and body mass index (BMI) were 4.65 ± 2.28 μU / ml and 15.87 ± 1.90 kg / m 2 respectively, both of which were significantly lower than those before treatment (5.83 ± 2.72) μU / ml and (16.44 ± 1.84) kg / m ~ 2 respectively (P <0.05). However, at 6 months of treatment, insulin levels increased at 3 months and had no significant difference with those before treatment (P> 0.05). At 6 months of treatment, serum cortisol and leptin levels were (10.13 ± 4.17) μg / dl and (2.14 ± 2.03) ng / ml, respectively, significantly lower than those before treatment [(13.25 ± 5.50) μg / dl and (2.89 ± 2.63) ng / ml] (P <0.05). There was no significant change in blood glucose, ghrelin and neuropeptide Y in children before and after treatment (P> 0.05). Conclusion Topiramate in children with epilepsy, serum leptin, cortisol levels decreased, which may be topiramate treatment of children with epilepsy leading to the decline in the level of body mass index important reason.