常用抗癫痫药对癫痫患者血同型半胱氨酸的影响  

Hyperhomocysteinemia in Epileptic Patients on Commonly Used Antiepileptic Drugs

作　　者：贾瑞华[1] 王小木[1] 李晓伟[1] 王莹[1] 景芸芸[1] 崔晓丽[1] 江文[1] 

机构地区：[1]第四军医大学西京医院神经内科,陕西西安710032

出　　处：《现代生物医学进展》2012年第9期1665-1667,共3页Progress in Modern Biomedicine

基　　金：国家自然科学基金资助项目(30870840;81071051)

摘　　要：目的:观察常用抗癫痫药对癫痫患者血同型半胱氨酸、叶酸、维生素B12浓度的影响。方法:比较45例服用单药治疗的癫痫患者(服用卡马西平11例,服用拉莫三嗪12例,服用奥卡西平9例,服用丙戊酸13例)血同型半胱氨酸、叶酸、维生素B12浓度的差异。结果:癫痫患者血同型半胱氨酸均高于正常,而叶酸和维生素B12均在正常范围内;服用拉莫三嗪的患者其血中同型半胱氨酸低于服用丙戊酸、卡马西平和奥卡西平的患者;服用卡马西平的患者血中叶酸高于服用拉莫三嗪、丙戊酸的患者(P<0.05);维生素B12在各用药组间无统计学差异。结论:长期服用抗癫痫药物可引起血中同型半胱氨酸的升高,而高同型半胱氨酸血症可增加心脑血管疾病的危险,故癫痫患者应常规给予补充叶酸、维生素B12,以使血同型半胱氨酸水平恢复正常。Objective：The aim of the present study was to observe the effect of commonly used antiepileptic drugs on plasma concentrations of total（t） homocysteine（Hcy） in epileptic patients.Methods： Patients on antiepileptic drugs monotherapy,with no other known cause of hyper-tHcy were enrolled.There are four groups tested.These groups were divided by drugs that patients used.Results： Plasma tHcy levels of all epileptic patients were significantly higher compared to physiological levels（P〈0.001）.Normal folate and vitmineB12 concentrations were observed in all subjects.Patients treated with lamotrigine exhibited mean plasma tHcy levels lower plasma tHcy levels of patients treated with carbamazepine,oxcarbazepine and valproic acid（P〈0.05）.Folate levels in patients taking carbamazepine were lower than those of patients treated with lamotrigine and valproic（P〈0.05）.Conclusions： Long-term antiepileptic drug therapy contributes to hyperhomocysteinemic.Because hyper-tHcy is a significantly higher risk of cerebrovascular disease,patients should be administered a supplement of folate and vitmineB12 to normalize plasma tHcy.

关 键 词：癫痫 叶酸 同型半胱氨酸 抗癫痫药物 

分 类 号：R742.1[医药卫生—神经病学与精神病学]