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目的 探讨托吡酯(TPM)对癫患儿酸碱平衡、电解质代谢的影响。方法 将2 0 0 2年3月至2 0 0 3年1 0月于河北医科大学附属第二医院儿科就诊的46例癫患儿根据治疗方法不同分成2组:( 1 )单药组2 6例(单独服用TPM) ;( 2 )联合用药组2 0例,为TPM与卡马西平(CBZ)、丙戊酸钠(VPA)、硝基安定(NZP)等联合应用。分别观察用药前(A时段)、用药后1～3个月(B时段)、用药3～1 2个月(C时段) 3个时段血气及电解质变化。结果 单药组血浆HCO- 3(mmol/L)A时段( 2 0 .1 0±2 .48) ,B时段( 1 6 .2 7±1 .0 6) ,C时段( 1 7 .82±1 . 79) ;联合用药组血浆HCO- 3(mmol/L)A时段( 2 2 . 1 0±2. 57) ,B时段( 1 5 .63±1 . 65) ,C时段( 1 6. 1 3±1 .0 7)。与本组A时段比较,两组用药后不同时段差异均分别具有显著性意义(P <0 . 0 1 )。但两组之间各时段差异均无显著性意义(P >0 .0 5)。结论 TPM可致癫患儿代偿性阴离子间隙正常型高氯性代谢性酸中毒。
Objective To investigate the effects of topiramate (TPM) on acid-base balance and electrolyte metabolism in epileptic children. Methods From March 2002 to January 2003, 46 children with epilepsy treated in pediatrics department of the Second Affiliated Hospital of Hebei Medical University were divided into two groups according to different treatment methods: (1) single drug group 2 6 cases (taking TPM alone); (2) 20 cases of combined treatment group, TPM and carbamazepine (CBZ), valproate (VPA), nitrazepam (NZP) and other combination. Blood gases and electrolytes were observed before treatment (A period), 1 ~ 3 months after treatment (B period) and 3 ~ 12 months after treatment (C period). Results The plasma levels of HCO-3 (mmol / L) A in the monotherapy group were 2.01 ± 2.48 in the B period (16.7 ± 1.06) and 17.82 ± 1.79). The plasma levels of HCO-3 (mmol / L) A in the combination group were (22.01 ± 2.57), in the B group (15.63 ± 1.65) and in the C group 1 3 ± 1 .0 7). Compared with the group A, the difference between the two groups after treatment was statistically significant (P <0.01). However, there was no significant difference between the two groups (P> 0.05). Conclusion TPM can cause compensatory anaphylactic normal anion hyperchlorinated metabolic acidosis in children with epilepsy.