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目的 了解托吡酯治疗后癫患儿血糖、胰岛素、食欲、甘丙肽、瘦素变化,探讨托吡酯对糖代谢的影响。方法 采用放射免疫法测定2 0 0 3年2～10月在河北省儿童医院就诊的4 1例癫患儿服用托吡酯(3 93±1 6 0 )mg/ (kg·d) 4个月前后血浆甘丙肽和血清瘦素和空腹血糖、胰岛素的浓度,并了解食欲变化。结果 服药后的血糖由4 .87mmol/L降至4 . 6 9mmol/L ;胰岛素由6 . 78mIU/L升至7. 4 2mIU/L ;甘丙肽服药后由2 6 14ng/L降到2 0 . 4 6ng/L ;而瘦素则从(1 .32±0 .5 7) μg/L升为(1. 91±1. 10 ) μg/L。服药前有4例食欲不好,服药后有19例出现食欲减退。结论 服用托吡酯会引起体内血糖降低、胰岛素升高、食欲下降,这些变化可能为托吡酯导致的甘丙肽降低和瘦素升高所致。
Objective To understand the changes of blood glucose, insulin, appetite, galanin and leptin in children with epilepsy after topiramate treatment, and to explore the influence of topiramate on glucose metabolism. Methods Radioimmunoassay was used to determine the effect of topiramate (3 93 ± 160 mg / (kg · d)) in 4 1 children with epilepsy treated at Children’s Hospital of Hebei Province from February to October 2003 Plasma galanin and serum leptin and fasting blood glucose, insulin concentrations, and to understand changes in appetite. Results After taking the blood glucose decreased from 4.87mmol / L to 4.69mmol / L; insulin increased from 6. 78mIU / L to 7.42mIU / L; after administration of galanin from 2 6 14ng / L to 2 0.46ng / L, while leptin increased from (1.32 ± 0.57) μg / L to (1.91 ± 1.10) μg / L. 4 cases before taking the poor appetite, after taking 19 cases of loss of appetite. Conclusion Topiramate may cause hypoglycemia, insulin increase and loss of appetite in vivo. These changes may be caused by the decrease of galanin and the increase of leptin caused by topiramate.