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目的探讨癫患儿血脂水平的改变及应用抗癫药物对血脂水平的影响。方法采用酶测定法分别测定2009年1月-2011年1月在小儿癫专科门诊随访治疗的55例癫患儿(全面性发作30例,单纯局限性发作18例,不能分类的发作7例)和30例健康体检儿童(健康对照组)血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)水平,分析癫患儿在单药或联合用药至少0.5 a后与健康对照组比较血脂水平的变化。结果癫患儿服用抗癫药物后引起其血脂水平的改变,与健康对照组血脂水平相比,血清TG、LDL-C显著升高(Pa<0.01),HDL-C水平显著下降(P<0.01);丙戊酸钠(VPA)单药治疗的癫患儿与健康对照组相比,TG、LDL-C升高及HDL-C降低,其差异有统计学意义(Pa<0.05,0.01),而单用VPA与联合用药组之间及两个联合用药组间血脂水平改变的差异均无统计学意义(Pa>0.05);联合用药组与健康对照组比较,其改变幅度VPA>VPA+拉莫三嗪>VPA+左乙拉西坦,但差异均无统计学意义(Pa>0.05)。结论癫患儿服用抗癫药物后存在血脂水平的改变,以单用VPA的改变最大。
Objective To investigate the changes of serum lipids in children with epilepsy and the effects of antiepileptic drugs on blood lipid levels. Methods Fifty-five children with epilepsy were enrolled in this study. The clinical data of 55 cases with epilepsy were followed up from January 2009 to January 2011 in pediatric epilepsy clinics (30 cases were generalized, 18 cases were localized and 18 cases were unclassified. (TC), triglyceride (TG), high density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) in 30 healthy children (healthy control group) children with single-drug or combination of at least 0.5 a after treatment with the control group lipid levels. Results Epilepsy children with anti-epileptic drugs caused changes in blood lipid levels, compared with the healthy control group serum TG, LDL-C were significantly increased (Pa <0.01), HDL-C levels were significantly decreased (P <0.01). Compared with healthy control group, the levels of TG, LDL-C and HDL-C in children with epilepsy treated with valproate (VPA) monotherapy were significantly lower (P <0.05, 0.01). However, there was no significant difference in lipid level between VPA group and combination group and between two combination groups (P> 0.05). Compared with healthy control group, the change of VPA> VPA + lamotrigine> VPA + levetiracetam, but the difference was not statistically significant (Pa> 0.05). Conclusion Epilepsy children with anti-epileptic drugs present changes in blood lipid levels to VPA single largest change.