抗癫药对大鼠甲状腺结构及分泌激素的影响  

Effect of Anti-Epileptic Drugs on Thyroid Structure and Endocrine Function in Rats

作　　者：孙雁[1] 高玉兴[2] 

机构地区：[1]淄博市妇幼保健院儿科,山东淄博255029 [2]山东省立医院儿科,济南250021

出　　处：《实用儿科临床杂志》2009年第17期1351-1353,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨丙戊酸(VPA)、奥卡西平(OXC)及左乙拉西坦(LEV)单药及联合用药对Wistar大鼠甲状腺结构及分泌激素的影响。方法雌性Wistar大鼠60只,随机分为VPA组、OXC组、LEV组、VPA加LEV组、OXC加LEV组、对照组,每组10只。按照分组给药,2次/d,每7 d称体质量1次。90 d后抽血放射免疫法(RIA)测定各组大鼠总三碘甲状腺原氨酸(TT3)、总四碘甲状腺原氨酸(TT4)、促甲状腺激素(TSH)。应用SPSS13.0软件进行统计分析。同时切除其甲状腺行病理切片,观察其甲状腺结构改变。结果与对照组比较,VPA组TSH减低(P<0.01),TT3、TT4均无统计学差异(Pa>0.05);OXC组TT3、TT4均减低(Pa<0.01),TSH升高(P<0.05);LEV组TT3、TT4、TSH均无统计学差异。OXC加LEV组与VPA加LEV组TT3、TT4、TSH比较均无统计学差异(Pa>0.05)。VPA组甲状腺滤泡体积略减小;OXC组滤泡体积增大,上皮细胞变薄;LEV组无明显变化,OXC加LEV组与VPA加LEV组滤泡体积大小不等。结论长期应用VPA和OXC可影响甲状腺结构及激素水平,LEV对甲状腺功能无影响,与VPA或OXC联合应用时可减轻其对甲状腺的影响。长期应用抗癫药物需监测甲状腺激素水平。Objective To investigate the effect of single usage of valproic acid（VPA） ,oxcarbazepine（OXC）,levetiracetam（LEV） and combined usage on thyroid structure and endocrine function of Wistar rats. Methods A total of 60 female Wistar rats, which were randomly divided into VPA group, OXC group, LEV group, VPA plus LEV group, OXC plus LEV group and control group. They were fed with drugs twice daily and weighed every 7 days in accordance with grouping. The serum levels of totle triiodothyronine （ TT3 ） , totle tetraiodothyronine （TT4 ）, thyroid stimulating hormone （TSH） were determined with radioimmunoassay（RIA） and pathological observations of thyroid tissue were made after 90 days. Results Compared with control group,TSH level of VPA group decreased（ P 〈 0.01 ）, while TT3 level,TT4 level had no statistical differences（ Pa 〉 0.05 ） ;TT3 and TT4 levels of OXC group decreased （P 〈 0.01 ）, while TSH level increased （P 〈 0.05 ） ;TT3 , TT4 and TSH levels of LEV group had no statistical differences（ Pa 〉 0.05 ）. TT3 ,TT4 and TSH levels of OXC plus LEV group and VPA plus LEV group had no statistical differences （Pa 〉 0.05 ）. Thyroid follicular volume of VPA group slightly reduced;thyroid follicular volume of OXC group increased while epithelial cells thinning;thyroid structure of LEV group had no alterations;thyroid follicular volume of OXC plus LEV group and VPA plus LEV group had no consistent alterations. Conclusions Long - terul application of VPA and OXC may arouse alterations of thyroid structure and hormone secretion. LEV has no effection on thyroid function,with VPA and OXC combined usage can reduce their effection on thyroid gland. Thyroid hormone level should be monitored when using anti- epileptic drugs（ADES） long- term in clinical work.

关 键 词：丙戊酸 奥卡西平 左乙拉西坦 甲状腺激素 甲状腺结构 小鼠 

分 类 号：R965[医药卫生—药理学]