高脂血症对癫痫患者丙戊酸钠肝毒性影响的临床研究  

Effect of hyperlipidemia on hepatotoxicity of sodium valproate in epileptic patients

作　　者：柴文[1] 梅竹君[1] 张骥[1] 王云霞[1] 谢旭芳[1] Chai Wen;Mei Zhujun;Zhang Ji;Wang Yunxia;Xie Xufang(Department of Neurology,Jiangxi Provincial People's Hospital,Nanchang,Jiangxi,330000,China)

机构地区：[1]江西省人民医院神经内科,江西南昌330000

出　　处：《当代医学》2019年第15期53-56,共4页Contemporary Medicine

基　　金：江西省卫生计生委科技计划(20175022)

摘　　要：目的本研究通过观察丙戊酸钠单药治疗的癫痫患者的血脂、肝功能及其他相关指标信息,来评估合并高脂血症的癫痫患者,使用丙戊酸钠治疗的疗效及肝毒性作用。方法选取2014年1月至2015年10月间收住本院神经内科确诊为癫痫并以丙戊酸钠片剂单药治疗的患者150例,平均年龄(20.5±15.3)岁,对患者进行随访,根据随访结果进行回顾性研究,并将患者分成单纯癫痫组和癫痫合并高血脂组。分析两组患者血脂水平、肝功能及丙戊酸钠血药浓度。结果入组时,癫痫合并高血脂组总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)均高于单纯癫痫组,而高密度脂蛋白胆固醇(HDL-C)低于单纯癫痫组,两组患者丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)及γ-谷氨酰转移酶(γ-GT)无明显差异;随访第8周,癫痫合并高血脂组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)高于单纯癫痫组,而高密度脂蛋白胆固醇(HDL-C)低于单纯癫痫组,癫痫合并高血脂组的肝功能,包括ALT、AST及γ-GT均高于单纯癫痫组。随访第16周,癫痫合并高血脂组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)高于单纯癫痫组,而高密度脂蛋白胆固醇(HDL-C)低于单纯癫痫组,癫痫合并高血脂组的肝功能指标,包括ALT、AST及γ-GT均高于单纯癫痫组,两组甘油三酯、低密度脂蛋白水平及肝功能指标较入组时及第8周时均明显升高,癫痫合并高血脂组肝功能指标升高百分比高于单纯癫痫组。患者入组时开始服用丙戊酸钠,随访第8周,标准化后的血药浓度,癫痫合并高血脂组血药浓度低于单纯癫痫组,随访第16周,标准化后的血药浓度,癫痫合并高血脂组血药浓度低于单纯癫痫组。分别对单纯癫痫组和癫痫合并高脂血症组的各项肝功能指标与丙戊酸钠血药浓度进行相关分析,发现癫痫合并高脂血症组肝功能指标和丙戊�Objective To evaluate the efficacy and hepatotoxicity of valproate sodium by observing the blood lipid,liver function and other related indicators in the treatment of epileptic patients with hyperlipidemia.Methods One hundred and fifty patients with epilepsy diagnosed treated with valproate single drug were selected in neurology department of Jiangxi Provincial People' s Hospital between January 2014 and October 2015, average age of (20.5±15.3) years old.Patients were divided into simple epilepsy group and epilepsy group combined with hyperlipidemia group according to the follow-up results.Blood lipid level,liver function and serum concentration of sodium valproate were analyzed in epileptic patients with hyperlipidemia.Results At the beginning of the experiment,total cholesterol,triglyceride,low density lipoprotein cholesterol (LDL-C) in the epilepsy combined hyperlipidemia group were higher than pure epilepsy group,and high density lipoprotein cholesterol (HDL-C) lower,alanine aminotransferase (ALT),aspartate aminotransferase (AST) and gamma glutamine transferase (gamma GT) has no obvious difference in the patients of two groups.At the 8th week of follow-up,total cholesterol (TC),triglyceride (TG) and LDL cholesterol (LDL-C) in the epilepsy group with hyperlipidemia were higher than those in the epilepsy group,while HDL cholesterol (HDL-C) was lower.Liver function indicators,including ALT,AST and gamma GT in the epilepsy combined hyperlipidemia group are higher than the epilepsy group.At the 16th week of follow-up,total cholesterol (TC), triglyceride (TG),low density lipoprotein cholesterol (LDL-C) in the epilepsy combined hyperlipidemia group higher than that of pure epilepsy group,and high density lipoprotein cholesterol (HDL-C) lower.Liver function indicators,including ALT,AST and gamma GT in the epilepsy combined hyperlipidemia group are higher than the epilepsy group.Triglyceride,low density lipoprotein levels and liver function index in two groups were significantly elevated at the beginning and 8th week

关 键 词：高脂血症 癫痫 丙戊酸钠 肝毒 临床 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R589.2[医药卫生—临床医学]