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目的探讨丙戊酸治疗是否影响癫疒间患儿血浆肉毒碱浓度。方法2003年4月至2004年2月在山东大学齐鲁医院儿科癫疒间治疗中心就诊且服用丙戊酸的癫疒间患儿32例,测定其血浆游离的和总的肉毒碱浓度,与对照组进行比较,并对丙戊酸治疗组患儿肉毒碱浓度与年龄、丙戊酸的剂量、疗程、联合用药、合并智力障碍、体重指数等因素作相关性分析。结果丙戊酸治疗组血浆游离的和总的肉毒碱浓度明显低于对照组,但肉毒碱浓度与年龄、丙戊酸剂量、疗程、合并智力障碍、联合用药等因素无显著相关性。丙戊酸治疗后治疗组的体重指数明显高于对照组,肉毒碱浓度与体重指数无显著相关性。结论丙戊酸治疗可引起肉毒碱减少和肥胖程度增加,年幼、丙戊酸剂量增大、疗程延长、合并智力障碍及联合用药并非是肉毒碱减少的危险因素,未发现肉毒碱减少与肥胖程度有关。
Objective To investigate whether valproate treatment affects plasma carnitine levels in children with epilepsy. Methods From April 2003 to February 2004, 32 children with epilepsy who were treated with valproic acid were enrolled in pediatric epilepsy treatment center of Qilu Hospital of Shandong University. Plasma free and total carnitine concentrations were measured. The control group was compared and the caffeine concentration in the valproic acid treatment group was compared with age, valproate dosage, duration of treatment, combination therapy, mental retardation, body mass index and other factors. Results The plasma free and total carnitine concentrations of valproic acid treatment group were significantly lower than those of the control group. There was no significant correlation between carnitine concentration and age, valproate dosage, duration of treatment, mental retardation and combination therapy. After treatment with valproic acid, the body mass index of the treatment group was significantly higher than that of the control group, and there was no significant correlation between carnitine concentration and body mass index. Conclusions Valproic acid treatment can cause the decrease of carnitine and the increase of obesity. In young patients, the dose of valproate increases, the course of treatment prolongs. The combination of mental retardation and combination therapy is not a risk factor for the reduction of carnitine. No carnitine Reduce the degree of obesity.