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目的观察托吡酯和丙戊酸钠对癫癎儿童血浆神经肽Y(NPY)的影响。方法将2003-01—2003-12在河北省儿童医院神经科就诊的特发性癫癎患儿随机分为托吡酯组(45例)和丙戊酸钠组(42例),在治疗前和治疗4个月后测定患儿体重、空腹血糖和NPY(放射免疫法)。结果托吡酯组治疗后出现体重下降[治疗前(19.92±10.61)/kg,治疗后(19.42±10.43)/kg,P<0.05],空腹血糖降低[治疗前(4.99±0.52)mmol/L,治疗后(4.65±0.30)mmol/L,P<0.01],以及NPY下降[治疗前(161.48±51.45)pg/mL,治疗后(141.01±54.94)pg/mL,P<0.01]。而丙戊酸钠组治疗后体重增加[治疗前(18.41±9.32)/kg,治疗后(20.40±9.84)kg,P<0.01],血糖下降[(治疗前4.73±0.70)mmol/L,治疗后(4.49±0.63)mmol/L,P<0.01],NPY升高[治疗前(151.64±30.4)pg/mL治疗后(166.97±24.50)pg/mL,P<0.05]。结论托吡酯治疗可引起癫癎患儿体重下降、血糖降低和血浆NPY的降低,丙戊酸钠治疗会导致NPY的水平升高、体重增加和血糖降低。
Objective To observe the effects of topiramate and valproate on plasma neuropeptide Y (NPY) in children with epilepsy. Methods From January 2003 to December 2003, children with idiopathic epilepsy in neurology department of Children’s Hospital of Hebei Province were randomly divided into topiramate group (n = 45) and sodium valproate group (n = 42). Before treatment and treatment After 4 months, the children’s body weight, fasting blood glucose and NPY (radioimmunoassay) were measured. Results After treatment, topiramate (19.92 ± 10.61) / kg before treatment (19.42 ± 10.43) / kg, P <0.05], fasting plasma glucose decreased [before treatment (4.99 ± 0.52) mmol / L, (4.65 ± 0.30) mmol / L, P <0.01], and decreased NPY (161.48 ± 51.45 pg / mL before treatment and 141.01 ± 54.94 pg / mL after treatment, P 0.01). However, the body weight of sodium valproate group was significantly higher than that before treatment (before treatment, 18.41 ± 9.32 kg / kg, 20.40 ± 9.84 kg / kg, P <0.01] (4.49 ± 0.63) mmol / L, P <0.01], NPY increased (151.64 ± 30.4 pg / mL before treatment, 166.97 ± 24.50 pg / mL, P <0.05). Conclusion Topiramate treatment can cause weight loss, hypoglycemia and plasma NPY in children with epilepsy. Sodium valproate treatment can lead to the increase of NPY, weight gain and blood sugar.