常用抗癫痫药对癫痫患者血同型半胱氨酸的影响

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。

Hyperhomocysteinemia in Epileptic Patients on Commonly Used Antiepileptic Drugs

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.