宫内暴露抗癫痫药物对子代的影响  

Effects of antiepileptic drugs on children of women taking the drugs during pregnancy

作　　者：石祺 王小姗[2] SHI Qi;WANG Xiaoshan(Department of Neurology,the Affiliated Wuxi People’s Hospital of Nanjing Medical University,Wuxi 214000;Department of Neurology,Brain Hospital Affiliated of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属无锡人民医院神经内科,江苏无锡214000 [2]南京医科大学附属脑科医院神经内科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2024年第9期1298-1304,共7页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省自然科学基金(BK20191127)。

摘　　要：癫痫是脑部神经元同步异常放电导致的一种脑功能障碍,是常见的神经系统疾病之一,患者需长期规律服用抗癫痫药物控制发作。对于妊娠妇女,抗癫痫药物可不同程度地通过胎盘屏障进入胎儿体内,对其产生不良风险。拉莫三嗪和左乙拉西坦潜在致畸风险最低,奥卡西平致畸风险较低,而托吡酯致畸风险较高,丙戊酸的致畸作用及对宫内暴露儿童神经心理发育的负面影响较大,应尽可能避免使用。目前抗癫痫药物的用药管理仍是一个临床难题,良好的孕前准备和孕期抗癫痫药物的合理决策至关重要。Epilepsy is a kind of brain dysfunction caused by abnormal synchronous discharge of brain neurons,and is one of the common diseases of the nervous system.Patients need to take anti-epileptic drugs regularly for a long time to achieve seizures-free.For pregnant women,antiepileptic drugs can enter the fetus through the placental barrier causing adverse effects.Lamotrigine and levetiracetam have the lowest potential teratogenic risk,oxcarbazepine has a low risk,topiramate has high risk,while valproic acid has the most severe teratogenic effect and negative effects on the neuropsychological development of children exposed in utero,and should be avoided as far as possible.At present,the management of antiepileptic drugs is still a difficult clinical problem.Pre-pregnancy preparation and rational decision-making of antiepileptic drugs usage during pregnancy are very important.

关 键 词：癫痫 抗癫痫药物 宫内暴露 畸形 子代发育障碍 

分 类 号：R742.1[医药卫生—神经病学与精神病学]