新型抗癫痫药物对新诊断青年男性癫痫患者性激素及性功能的影响研究  

Impact of New Novel-Antiepileptic Drugs on Sex Hormones and Sexual Function in Young Male Patients with Newly Diagnosed Epilepsy

作　　者：凌秀明[1] 龙海[2] 秦培英[3] 潘明明 李星虹[4] 邓海英[5] LING Xiuming;LONG Hai;QIN Peiying;PAN Mingming;LI Xinghong;DENG Haiying(Department of Nerve Electrophysiology,the Second People's Hospital of Qinzhou,Qinzhou 535000,China;Department of Andrology,the Second People's Hospital of Qinzhou,Qinzhou 535000,China;Department of Neurology,the Second People's Hospital of Qinzhou,Qinzhou 535000,China;Department of Pediatrics,the Second People's Hospital of Qinzhoul,Qinzhou 535000,China;Department of Pharmacy,the Second People's Hospital of Qinzhou,Qinzhou 535000,China)

机构地区：[1]广西壮族自治区钦州市第二人民医院神经电生理科,535000 [2]广西壮族自治区钦州市第二人民医院男科,535000 [3]广西壮族自治区钦州市第二人民医院神经内科,535000 [4]广西壮族自治区钦州市第二人民医院儿科,535000 [5]广西壮族自治区钦州市第二人民医院药学部,535000

出　　处：《实用心脑肺血管病杂志》2021年第4期98-104,共7页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：广西壮族自治区卫生厅自筹经费科研课题(Z2012682)。

摘　　要：背景癫痫患者需长期或大剂量服用抗癫痫药物(AEDs)来控制病情,既往临床多关注AEDs所致的肝肾功能损伤,忽视了其对生殖功能的影响。目前关于AEDs对癫痫患者生殖功能的影响尚存在争议。目的比较奥卡西平、拉莫三嗪、左乙拉西坦、托吡酯对新诊断青年男性癫痫患者性激素及性功能的影响。方法回顾性选取2016—2019年钦州市第二人民医院神经内科收治的新诊断青年男性癫痫患者200例,基于其癫痫发作类型随机给予新型AEDs治疗,将其中服用奥卡西平者分为A组,服用拉莫三嗪者分为B组,服用左乙拉西坦者分为C组,服用托吡酯者分为D组,各50例。比较四组患者治疗前及治疗后6、12个月催乳素(PRL)、卵泡刺激素(FSH)、促黄体生成素(LH)、睾酮(T)、雌二醇(E2)水平、国际勃起功能指数5(IIEF-5)评分、早泄诊断工具(PEDT)评分。结果最终A组纳入42例,B组纳入43例,C组纳入46例,D组纳入40例。时间与治疗方法在LH水平上存在交互作用(P <0.05),在PRL、FSH、T、E2水平上无交互作用(P>0.05);治疗方法在PRL、FSH、LH、T水平上主效应显著(P <0.05),在E2水平上主效应不显著(P>0.05);时间在PRL、FSH、LH水平上主效应显著(P <0.05),在T、E2水平上主效应不显著(P>0.05)。A组患者治疗后6、12个月FSH水平及治疗后12个月LH、T水平分别高于本组治疗前,治疗后12个月FSH水平高于本组治疗后6个月(P <0.05);C组患者治疗后6、12个月T水平分别高于本组治疗前,治疗后12个月T水平高于本组治疗后6个月(P <0.05);D组患者治疗后6、12个月PRL水平分别低于本组治疗前,LH水平分别高于本组治疗前(P <0.05);D组患者治疗后12个月PRL水平低于本组治疗后6个月,LH水平高于本组治疗后6个月(P <0.05)。B、C、D组患者治疗后12个月FSH水平低于A组(P <0.05);C组患者治疗后12个月T水平高于B组;D组患者治疗后6、12个月PRL水平低于A、B、C组,LH水平高于A、B�Background Patients with epilepsy need long-term or high-dose antiepileptic drugs(AEDs)to control their condition.In the past,more attention were paid to the damage of liver and kidney function caused by AEDs,while the impact of AEDs on reproductive function was ignored.At present,the impact of AEDs on reproductive function of epileptic patients is still controversial.Objective To compare the impact of Oxcarbazepine,Lamotrigine,Levetiracetam and Topiramate on sex hormones and sexual function in young male patients with newly diagnosed epilepsy.Methods Two hundred young male patients with newly diagnosed epilepsy in the Department of Neurology,the Second People’s Hospital of Qinzhou from 2016 to 2019 were enrolled in this study.According to the novel AEDs used,all patients were randomly divided into four groups(group A:Oxcarbazepine,group B:Lamotrigine,group C:Levetiracetam,group D:Topiramate),with 50 cases in each group.Levels of prolactin(PRL),follicle stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),estradiol(E2),and scores of International Index of Erectile Function-5(IIEF-5)and Premature Ejaculation Diagnosis Tools(PEDT)in the four groups before treatment,6 months and 12 months after treatment were compared.Results Forty-two cases in group A,43 cases in group B,46 cases in group C and 40 cases in group D were included in the final analysis.There was an interaction between time and treatment options on the level of LH(P<0.05),but no interaction existed between time and treatment options on levels of PRL,FSH,T,E2(P>0.05).The main effect of treatment options was significant on levels of PRL,FSH,LH,T(P<0.05),but not significant on the level of E2(P>0.05).The main effect of time was significant on levels of PRL,FSH,LH(P<0.05),but not significant on levels of T,E2(P>0.05).In the group A,FSH level at 6,12 months after treatment,LH and T level at 12 months after treatment were respectively higher than those before treatment(P<0.05);FSH level at 12 months after treatment was higher than that at 6 mon

关 键 词：癫痫 男性 青年 新型抗癫痫药物 性激素 性功能 

分 类 号：R742.1[医药卫生—神经病学与精神病学]