目的为了解不同抗癫痫药物治疗癫痫患儿对其血清尿酸水平的影响。方法前瞻性对178例癫痫患儿采用尿酸酶-过氧化物酶偶联法检测了其服药前后血清尿酸水平,并与正常对照组对照。结果在平均服药(2.71±2.23)年后,丙戊酸钠组、左乙拉西坦组、丙戊酸钠联合左乙拉西坦组、丙戊酸钠联合奥卡西平组、丙戊酸钠联合拉莫三嗪组及多药组(丙戊酸钠、奥卡西平、左乙拉西坦、拉莫三嗪、妥泰)血清尿酸水平较服药前增高,差异有统计学意义(t值分别为5.45、4.93、3.43、2.44、4.47、3.77,均P〈0.05),而奥卡西平联合左乙拉西坦组服药前后差异无统计学意义(t=1.53,P〉0.05)。其中丙戊酸钠组、左乙拉西坦组、丙戊酸钠联合奥卡西平组,多药组血清尿酸水平高于正常对照组,差异有统计学意义(t值分别为3.50、2.94、3.21、2.59,均P〈0.05)。结论不同抗癫痫药物对血清尿酸水平影响不同,提示临床医生注意定期监测服用抗癫痫药物患儿血清尿酸水平变化以便早期发现肾功能损伤。
Objective To investigate the effects of different anti-epilepsy drugs( AEDs) on serum uric acid levels of children with epilepsy under AEDs treatment. Methods The serum uric acid levels of 178 children with epilepsy before and after medication were detected prospectively using uric acid enzyme- peroxide enzyme coupling method,then the results were compared with normal control group.Results After( 2. 71±2. 23) years on average,the serum uric acid levels in valproate group,levetiracetam group,valproate combined with levetiracetam group,valproate combined with oxcarbazepine group,valproate combined with lamotrigine group,and multi-drug group( valproate,oxcarbazepine,levetiracetam,lamotrigine,and topiramate) were statistically significantly higher than those before medication( t =5. 45,4. 93,3. 43,2. 44,4. 47,3. 77,P0. 05),but there was no statistically significant difference in oxcarbazepine combined with levetiracetam group between before and after medication( t = 1. 53,P 〈0. 05). The serum uric acid levels in valproate group,levetiracetam group,valproate combined with oxcarbazepine group,multi- drug groups were statistically significantly higher than that in normal control group( t = 3. 50,2. 94,3. 21,2. 59,P〉0. 05). Conclusion Different anti-epileptic drugs had different impacts on serum uric acid levels,which suggests that the clinicians should pay attention to monitoring changes of serum uric acid levels in children with AEDs medication for early detection of renal injury.