癫痫杂志

癫痫杂志

奥卡西平、左乙拉西坦、拉莫三嗪对新诊断成年男性癫痫患者甲状腺激素的影响

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目的 探讨新型抗癫痫药物(奥卡西平、左乙拉西坦、拉莫三嗪)对成年男性癫痫患者甲状腺激素的影响,为指导临床用药提供参考。 方法 收集 2015 年 4 月—2016 年 11 月于四川省人民医院癫痫中心就诊连续登记的新诊断成年男性癫痫患者 38 例,发作类型符合国际抗癫痫联盟(ILAE)1981 年发作分类的全面性发作和部分性发作继发强直阵挛发作。随机予以奥卡西平、左乙拉西坦、拉莫三嗪进行单药治疗,每组单药治疗≥6 个月。同时收集年龄相当的健康志愿者 26 名。对患者治疗前和服药 6 个月后以及志愿者的甲状腺激素进行检测,并进行比较。 结果 男性癫痫患者服药前与健康对照组相比,甲状腺激素水平无差异(P>0.05);奥卡西平组服药 6 个月后,总甲状腺素、游离甲状腺素明显低于服药前(P<0.05);而左乙拉西坦及拉莫三嗪治疗组的甲状腺激素水平与治疗前相比较,无统计学差异(P>0.05)。 结论 奥卡西平能降低血清总甲状腺素、游离甲状腺素,对成年男性癫痫患者甲状腺激素产生不利影响。

Objectives To investigate the effects of new antiepileptic drugs [oxcarbazepine (OXC), levetiracetam (LEV), lamotrigine (LTG)] on thyroid hormones in male adults with epilepsy. Methods Thirty-eight newly diagnosed male adult patients with epilepsy were enrolled in the Epilepsy Center of Sichuan Province People's Hospital from April 2015 to November 2016. The diagnosis was in line with the classification of epilepsy defined by the International League Against Epilepsy (ILAE, 1981). Only patients with generalized or secondary generalized epilepsy were recruited into the present study. Individual treatment with OXC, LEV, or LTG was randomly assigned to the 38 patients. Thyroid hormones was measured before treatment and 6 months after taking the medicine. Followed by an analysis of the comparison between the treated patients and healthy volunteers (healthy controls) as well as the changes and differences between the patients themselves before and after treatment. Results There was no significant difference in the thyroid hormone levels between male patients with epilepsy before taking the medicine and healthy controls (P>0.05). After 6 months, total thyroxine (TT4) and free thyroxine (FT4) in OXC group was significantly lower than the baseline (P<0.05). However, the thyroid hormone levels in the LEV group and LTG group showed no statistical difference before and after treatment (P>0.05). Conclusions OXC can reduce serum total thyroxine (TT4) and free thyroxine (FT4), which might be harmful to thyroid hormone of patients.

关键词: 癫痫; 抗癫痫药物; 甲状腺激素

Key words: Epilepsy; Antiepileptic drugs; Thyroid hormone

引用本文: 吴冬梅, 纪法源, 孙红斌. 奥卡西平、左乙拉西坦、拉莫三嗪对新诊断成年男性癫痫患者甲状腺激素的影响. 癫痫杂志, 2018, 4(5): 396-399. doi: 10.7507/2096-0247.20180065 复制

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1. Ngugi AK, Bottomley C, Kleinschmidt I, et al. Estimation of the burden of active and life-time epilepsy: a meta-analytic approach. Epilepsia, 2010, 51(5): 883-890.
2. 洪震. 癫痫流行病学研究. 中国现代神经疾病杂志, 2014, (11): 919-923.
3. 朱衡亚, 刘泉坤, 王庄, 等. 甲状腺功能亢进伴癫痫样发作相关性临床分析. 现代中西医结合杂志, 2008, (30): 4766-4767.
4. 张雄伟, 张以善, 宋晶, 等. 甲状腺功能亢进症患者治疗前后的脑功能及脑血流动力学改变. 临床神经电生理学杂志, 2006, (2): 87-89.
5. Zhang Y X, Shen C H, Lai Q L, et al. Effects of antiepileptic drug on thyroid hormones in patients with epilepsy: A meta-analysis. Seizure, 2016, 35: 72-79.
6. Verrotti A, Mencaroni E, Cofini M, et al. Valproic Acid Metabolism and its Consequences on Sexual Functions. Curr Drug Metab, 2016, 17(6): 573-581.
7. Castro-Gago M, Novo-Rodriguez MI, Gomez-Lado C, et al. Evolution of subclinical hypothyroidism in children treated with antiepileptic drugs. Pediatr Neurol, 2007, 37(6): 426-430.
8. Luef G, Kramer G, Stefan H. Oxcarbazepine treatment in male epilepsy patients improves pre-existing sexual dysfunction. Acta Neurol Scand, 2009, 119(2): 94-99.
9. Calabro R S, Italiano D, Pollicino P, et al. Oxcarbazepine-related retrograde ejaculation. Epilepsy Behav, 2012, 25(2): 174-175.
10. Savic I. Sex differences in human epilepsy. Exp Neurol, 2014, 259: 38-43.
11. 常琳, 王小姗. 中国癫痫流行病学调查研究进展. 国际神经病学神经外科学杂志, 2012, 39(2): 161-164.
12. Hamed SA. The effect of epilepsy and antiepileptic drugs on sexual, reproductive and gonadal health of adults with epilepsy. Expert Rev Clin Pharmacol, 2016, 9(6): 807-819.
13. Hamed SA. Neuroendocrine hormonal conditions in epilepsy: relationship to reproductive and sexual functions. Neurologist, 2008, 14(3): 157-169.
14. Blume WT. Low fertility in men with epilepsy: unhappy, uninterested, unable. Epilepsy Curr, 2009, 9(3): 69-70.
15. Verrotti A, Loiacono G, Laus M, et al. Hormonal and reproductive disturbances in epileptic male patients: emerging issues. Reprod Toxicol, 2011, 31(4): 519-527.
16. Roste LS, Tauboll E, Haugen TB, et al. Alterations in semen parameters in men with epilepsy treated with valproate or carbamazepine monotherapy. Eur J Neurol, 2003, 10(5): 501-506.
17. Cansu A. Antiepileptic drugs and hormones in children. Epilepsy Res, 2010, 89(1): 89-95.
18. Isojarvi JI, Turkka J, Pakarinen AJ, et al. Thyroid function in men taking carbamazepine, oxcarbazepine, or valproate for epilepsy. Epilepsia, 2001, 42(7): 930-934.
19. Tiihonen M, Liewendahl K, Waltimo O, et al. Thyroid status of patients receiving long-term anticonvulsant therapy assessed by peripheral parameters: a placebo-controlled thyroxine therapy trial. Epilepsia, 1995, 36(11): 1118-1125.
20. Lossius MI, Tauboll E, Mowinckel P, et al. Reversible effects of antiepileptic drugs on thyroid hormones in men and women with epilepsy: a prospective randomized double-blind withdrawal study. Epilepsy Behav, 2009, 16(1): 64-68.
21. Vainionpaa LK, Mikkonen K, Rattya J, et al. Thyroid function in girls with epilepsy with carbamazepine, oxcarbazepine, or valproate monotherapy and after withdrawal of medication. Epilepsia, 2004, 45(3): 197-203.
22. Verrotti A, Basciani F, Morresi S, et al. Thyroid hormones in epileptic children receiving carbamazepine and valproic acid. Pediatr Neurol, 2001, 25(1): 43-46.
23. Kim SH, Chung HR, Kim H, et al. Subclinical hypothyroidism during valproic acid therapy in children and adolescents with epilepsy. Neuropediatrics, 2012, 43(3): 135-139.
24. Isojarvi JI, Pakarinen AJ, Myllyla VV. Thyroid function in epileptic patients treated with carbamazepine. Arch Neurol, 1989, 46(11): 1175-1178.
25. Bentsen KD, Gram L, Veje A. Serum thyroid hormones and blood folic acid during monotherapy with carbamazepine or valproate. A controlled study. Acta Neurol Scand, 1983, 67(4): 235-241.
26. 喻良, 黄雨兰, 孙红斌, 等. 托吡酯与卡马西平对成年癫痫患者甲状腺激素的影响. 中风与神经疾病杂志, 2007, 24(3): 315-317.
27. Garoufi A, Koemtzidou E, Katsarou E, et al. Lipid profile and thyroid hormone concentrations in children with epilepsy treated with oxcarbazepine monotherapy: a prospective long-term study. Eur J Neurol, 2014, 21(1): 118-123.
28. 李济世. 奥卡西平治疗癫痫对甲状腺激素水平影响的观察. 贵州医药, 2016, 40(7): 728-730.