育龄女性癫痫患者的生殖内分泌紊乱相关危险因素分析  

Risk Factors Related with Reproductive Endocrinology Disorder in Chinese Women of Child-bearing Age with Epilepsy

作　　者：陈柳静[1] 周列民[1] 周珏倩[1] 王倩[1] 方子妍[1] 陈子怡[1] 陈树达[1] 杨丽白[1] 戴启鳞[1] 

机构地区：[1]中山大学附属第一医院神经科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2010年第2期302-305,308,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2007B0315102004);广东省科技计划项目(2009B060700108)

摘　　要：【目的】了解中国育龄女性癫痫患者发生生殖内分泌紊乱的相关危险因素,为临床决策提供依据。【方法】收集符合研究标准的102例女性癫痫患者的临床资料,将癫痫起病年龄、发作类型、发作频率、癫痫病程、抗癫痫药物(AED)种类、开始服用AED的年龄、用药持续时间7个因素分组,分析各因素与月经稀发/闭经、多囊卵巢(PCO)、高雄激素血症(HA)、多囊卵巢综合征(PCOS)的关系。【结果】癫痫起病年龄≤14岁者较起病年龄>14岁者HA高发并具统计学意义;服用丙戊酸钠的患者月经稀发/闭经、PCO、HA、PCOS发生率分别达40.63%、50.00%、15.65%和34.38%,显著高于未用药组及其他用药组。Logistics回归分析结果表明:服用丙戊酸钠是发生生殖内分泌紊乱及PCOS的危险因素。癫痫起病年龄≤14岁是HA的危险因素。【结论】服用丙戊酸钠是中国育龄女性癫痫患者发生生殖内分泌紊乱乃至PCOS的危险因素,癫痫起病年龄≤14岁是HA的危险因素。【Objective】 This study was designed to identify the risk factors related with reproductive endocrinology disorder in Chinese women of child-bearing age with epilepsy. 【Methods】 The clinical data of 102 women with epilepsy were collected. The patient were grouped according to seven aspects （seizure onset age, seizure type, seizure frequency, duration of epilepsy, AED type, age of start AED therapy and duration of therapy） and the contribution of these factors in development of PCOS and its components were analyzed. 【Results】 The incidence of hyperandrogenemia in the patients with an early onset age （≤14 years old） was higher than the ones with an onset age〉 14 years old. Onset age≤14 was the risk factor of hyperandrogenemia in logistic regression analysis. The incidence of a/oligomenorrhea, polycystic ovaries, hyperandrogenemia and PCOS in the valproate-treated women were 40.63%, 50.00%, 15.65%, and 34.38%, respectively, which were higher than the no-therapy group and nonvalproate treated group. Valproate therapy was the risk factor of PCOS and its components. 【Conclusion】 Valproate therapy was the risk factor of PCOS and its components in Chinese women of child-bearing age with epilepsy. Onset age ≤14 was the risk factor of hyperandrogenemia.

关 键 词：癫痫 女性 生殖内分泌紊乱 危险因素 育龄 抗癫痫药物 丙戊酸钠 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R711.75[医药卫生—临床医学]