托吡酯治疗后癫癎患儿体重和血浆甘丙肽的变化  

Changes of body weight and galanin in epileptic children treated with topiramate

作　　者：施荣富[1] 王克玲[1] 李清华[1] 郑华城[1] 杨华芳[1] 唐红霞[1] 孙素真[1] 王丽辉[1] 田杰[1] 

机构地区：[1]河北省儿童医院神经内科,石家庄050031

出　　处：《中华儿科杂志》2007年第3期199-202,共4页Chinese Journal of Pediatrics

摘　　要：目的探讨癫癎患儿托吡酯治疗后体重变化与血浆甘丙肽的关系。方法对服用托吡酯的61例癫癎患儿用放射免疫法测定治疗前后血浆甘丙肽浓度和观察身高、体重变化,并以16例健康儿童作为对照。结果①服托吡酯后22例(36.1%)体重下降,该组甘丙肽浓度降低有统计学意义(t=2.91,P<0.01)。体重增加组甘丙肽变化没有统计学意义(t=1.67,P>0.05)。对照组甘丙肽变化无统计学意义(t=1.72,P>0.05)。②体重下降组中18例(81.8%)患儿食欲变差,与体重增加组相比,差异有统计学意义(x^2=28.50,P<0.001)。③食欲差组甘丙肽浓度降低有统计学意义(t=4.84,P<0.001),而食欲好组下降无统计学意义(t=1.04,P>0.05)。④癫癎患儿治疗后体重指数的下降[(17.48±2.22)kg/m^2比(15.24±2.38)kg/m^2]有统计学意义(t=8.628,P<0.01)。对照组是增加的。结论服用托吡酯后部分癫痫患儿体重会有显著下降和食欲减退,同时伴有血浆中甘丙肽水平显著的下降。提示托吡酯治疗引起的体重降低和食欲减退可能与甘丙肽浓度降低有关。Objective Topiramate is a new broad-spectrum anti-epileptic drug. Decreased body weight and appetite are common side effects of topiramate. The side effect affects the growth and development in children greatly. Little is known about the mechanisms of topiramate-induced weight loss and decreased appetite in children with epilepsy in China and abroad, galanin is one of factors that affect appetite. It is a neuroendocrine peptide and play an important role in the control of appetite and body weight in the mechanism of hormone release. The purpose of this study was to explore the mechanism of topiramateinduced weight loss in children with epilepsy and the relation of weight loss with change of galanin, theredy to provide evidences for improvement of quality of life, compliance to treatment and reduce side effects of growth and development in children with epilepsy. Methods Totally 61 patients with especial epilepsy were enrolled into this study and the disease was defined by clinical manifestations and electroencephalography （EEG）. Among them 32 cases had generalized seizures and 29 had local seizures. Sixteen normal children were enrolled as control group. The patients＇ age ranged from 0.5 to 14 （4.76 ±4.05） years and the patients were instructed to take 0. 5 - 1 mg/kg of topiramate per day, with 0. 5 - 1 mg/kg every 3 - 5 d increased to maximum of 3 - 8 mg/kg per day. Patients continued receiving the doses for 4 months. All patients＇ serum galanin levels and body height and weight and hepatic function were detected before and after antiepileptic drugs treatment. The galanin was detected by using radioimmunoassay. Results After treatment with topiramate （61 cases） for 4 months, plasma galanin [ （22. 01 ±8. 12） pg/ml] declined as compared with baseline [ （26. 56 ± 9. 35） pg/ml, t =2. 85,P〈0. 01] in children with epilepsy. Twenty-two of 61 patients lost weight, their plasma galanin concentration was significantly lower [ （26. 51 ± 10. 00） pg/ ml vs. （20.45 ±8.09） pg/ml,t =2.91,

关 键 词：癫痫 果糖 体重 加兰肽 

分 类 号：R742.1[医药卫生—神经病学与精神病学]