托吡酯与丙戊酸钠对癫痫患儿脑电活动及糖脂代谢的影响

目的:探讨托吡酯与丙戊酸钠对癫痫患儿脑电活动及相关代谢指标的影响。方法:选择66例癫痫患儿进行研究,并采用随机方法分为两组,其中观察组予托吡酯治疗,对照组予丙戊酸钠治疗。比较治疗前后患儿脑电活动及糖脂代谢指标差异。结果:治疗后,观察组患儿癫痫样放电(6.77±1.04)次、δ(12.77±2.32)次、θ(21.63±2.77)次、α(20.54±2.55)次、β(11.18±1.72)次均较治疗前和对照组明显减少(P0.05)。观察组患儿经治疗后体质指数(BMI)(14.43±1.29)kg/m2、空腹血糖(FPG)(4.53±0.51)mmol/L较治疗前和对照组明显减少(P0.05),空腹胰岛素(FINS)(9.78±1.44)m U/L较治疗前和对照组明显增加(P0.05)。两组患者经治疗后脂代谢各项指标甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(L-DLD)、高密度脂蛋白(H-DLD)均较治疗前无明显变化(P0.05),且两组间比较无显著差异(P0.05)。结论:托吡酯能更有效控制癫痫患儿的脑电活动,但会导致糖代谢异常及患儿体质量指数减少,而丙戊酸钠对癫痫患儿糖脂代谢及体质量指数的影响较小,临床应根据具体情况合理选择用药。

Influence of Topiramate and SodiumValproate on EEG Activity and Glucoseand Lipid Metabolismof Epileptic Children

Objective:To explore the influence of topiramate and sodium valproate on EEG activity and glucose and lipidmetabolism of epileptic children.Methods:66 cases of epileptic children were randomly divided into two groups. The observation groupwas treated with topiramate, while the control group was treated with sodiumvalproate. The brain electrical activity and glucose and lipidmetabolism were compared before and after treatment.Results:After treatment, the epileptic discharges (6.77± 1.04), delta (12.77±2.32), theta (21.63± 2.77), alpha (20.54± 2.55), beta (11.18± 1.72) of observation group were decreased significantly compared withthose before treatment and control group (P<0.05). After treatment, BMI (14.43± 1.29) kg/m2, FPG (4.53± 0.51) mmol/L of observationgroup were significantly decreased (P<0.05), FINS (9.78± 1.44) mU/L was significantly increased (P<0.05) compared with that beforetreatment. After treatment, the two groups of patients of lipid metabolism of TG, LDL-C, TC, HDL-C were significantly less than beforetreatment (P>0.05), and there was no significant difference between the two groups (P>0.05).Conclusion:Topiramate could moreeffectively control the EEG activity of epileptic children, but it could lead to a reduction in glucose metabolism and children''s body massindex (BMI). Sodium valproate had little influence on the glucose and lipid metabolism and body mass index of epileptic children. Drugsshould be rationally applied according to the specific situation.