奥卡西平、左乙拉西坦、拉莫三嗪对癫痫患者甲状腺激素水平和叶酸代谢的影响  

Effect of Oxcarbazepine,Levetiracetam,Lamotrigine on Thyroid Hormone Levels and Folic Acid Metabolism in Patients with Epilepsy

作　　者：肖源 何继红 徐建华 Xiao Yuan;He Jihong;Xu Jianhua(Jiading District Central Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 201800,China)

机构地区：[1]上海健康医学院附属嘉定区中心医院,上海嘉定201800

出　　处：《中国社区医师》2023年第36期52-54,共3页Chinese Community Doctors

摘　　要：目的:探讨奥卡西平(OXC)、左乙拉西坦(LEV)、拉莫三嗪(LTG)对癫痫患者甲状腺激素水平和叶酸代谢的影响。方法:选取2021年2月—2022年1月上海健康医学院附属嘉定区中心医院收治的癫痫患者168例作为研究对象,随机分为OXC组、LEV组、LTG组,各56例。OXC组采用OXC单药治疗,LEV组采用LEV单药治疗,LTG组采用LTG单药治疗。比较三组甲状腺激素、叶酸和同型半胱氨酸水平。结果:治疗前,三组总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平比较,差异无统计学意义(P>0.05);治疗后,OXC组TT4、FT4水平低于治疗前,且低于LEV组与LTG组,差异有统计学意义(P<0.05)。治疗前,三组叶酸、同型半胱氨酸水平比较,差异无统计学意义(P>0.05)。治疗后,三组叶酸水平均低于治疗前,但LTG组高于OXC组与LEV组,差异有统计学意义(P<0.05);三组同型半胱氨酸水平均高于治疗前,且LTG组高于OXC组与LEV组,差异有统计学意义(P<0.05)。结论:OXC会影响癫痫患者甲状腺激素水平,OXC、LEV、LTG均可影响癫痫患者叶酸及同型半胱氨酸水平,其中LTG对同型半胱氨酸水平的影响大于OXC与LEV。Objective:To explore the effects of oxcarbazepine(OXC),levetiracetam(LEV),lamotrigine(LTG)on thyroid hormone levels and folic acid metabolism in patients with epilepsy.Methods:A total of 168 patients with epilepsy admitted to Jiading District Central Hospital Affiliated to Shanghai University of Medicine&Health Sciences from February 2021 to January 2022 were selected as the study subjects.The patients were randomly divided into OXC group,LEV group and LTG group,with 56 cases in each group.OXC monotherapy was used in the OXC group,LEV monotherapy was used in the LEV group,and LTG monotherapy was used in the LTG group.Thyroid hormone,folic acid and homocysteine levels were compared among the three groups.Results:Before treatment,there was no significant difference in the levels of thyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4)and thyroid-stimulating hormone(TSH)among three groups(P>0.05);After treatment,the levels of TT4 and FT4 in the OXC group were lower than those before treatment,and lower than those in the LEV group and the LTG group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the levels of folic acid and homocysteine among three groups(P>0.05).After treatment,the level of folic acid in the three groups was lower than that before treatment,but the level of folic acid in the LTG group was higher than that in the OXC group and the LEV group,and the difference was statistically significant(P<0.05);the level of homocysteine in the three groups was higher than that before treatment,and the level of homocysteine in the LTG group was higher than that in the OXC group and the LEV group,and the difference was statistically significant(P<0.05).Conclusion:OXC affects the level of thyroid hormone in patients with epilepsy,and OXC,LEV and LTG can affect the levels of folic acid and homocysteine in patients with epilepsy,and LTG has a greater effect on the level of homocysteine than OXC and LEV.

关 键 词：癫痫 抗癫痫药物 甲状腺激素 叶酸 同型半胱氨酸 

分 类 号：R742.1[医药卫生—神经病学与精神病学]